Jens Bedke1, Laurence Albiges2, Umberto Capitanio3, Rachel H Giles4, Milan Hora5, Thomas B Lam6, Börje Ljungberg7, Lorenzo Marconi8, Tobias Klatte9, Alessandro Volpe10, Yasmin Abu-Ghanem11, Saeed Dabestani12, Sergio Fernández-Pello13, Fabian Hofmann14, Teele Kuusk15, Rana Tahbaz16, Thomas Powles17, Axel Bex18. 1. Department of Urology, University Hospital Tuebingen, Tuebingen, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany. 2. Department of Cancer Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France. 3. Department of Urology, San Raffaele Scientific Institute, Milan, Italy; Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy. 4. Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands; Patient Advocate, International Kidney Cancer Coalition, Utrecht, The Netherlands. 5. Department of Urology, University Hospital Pilsen and Charles University Faculty of Medicine in Pilsen, Pilsen, Czech Republic. 6. Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK. 7. Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden. 8. Department of Urology, Coimbra University Hospital, Coimbra, Portugal. 9. Department of Urology, Royal Bournemouth Hospital, Bournemouth, UK; Department of Surgery, University of Cambridge, Cambridge, UK. 10. Department of Urology, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy. 11. Department of Urology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel. 12. Department of Translational Medicine, Division of Urological Cancers, Lund University, Malmö, Sweden. 13. Department of Urology, Cabueñes University Hospital, Gijón, Spain. 14. Department of Urology, Sunderby Sjukhus, Umeå University, Luleå, Sweden. 15. Department of Urology, Darent Valley Hospital, Dartford and Gravesham NHS Trust, Dartford, UK. 16. Department of Urology, Elbe Kliniken, Stade, Germany. 17. The Royal Free NHS Trust and Barts Cancer Institute, Queen Mary University of London, London, UK. 18. The Royal Free London NHS Foundation Trust, London, UK; UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: a.bex@ucl.ac.uk.
Abstract
Longer follow-up and new trial data from phase 3 randomised controlled trials investigating immune checkpoint blockade (PD-1 or its ligand PD-L1) in advanced clear-cell renal cell carcinoma (RCC) have recently become available. The CheckMate 9ER trial demonstrated an improved progression-free survival (PFS) and overall survival (OS) benefit for the combination of cabozantinib plus nivolumab. A Keynote-426 update demonstrated an ongoing OS benefit for pembrolizumab plus axitinib in the intention-to-treat population, with a PFS benefit seen across all International Metastatic Database Consortium (IMDC) subgroups, while an update of CheckMate 214 confirmed the long-term benefit of ipilimumab plus nivolumab in IMDC intermediate and poor risk patients. The RCC Guidelines Panel continues to recommend these tyrosine kinase inhibitors + immunotherapy (IO) combination across IMDC risk groups in advanced first-line RCC and dual immunotherapy of ipilimumab and nivolumab in IMDC intermediate and poor risk. PATIENT SUMMARY: New data from trials of immune checkpoint inhibitors for advanced kidney cancer confirm a survival benefit with the combination of cabozantinib plus nivolumab and pembrolizumab plus axitinib and ipilimumab plus nivolumab. These combination therapies are recommended as first-line treatment for advanced kidney cancer.
Longer follow-up and new trial data from phase 3 randomised controlled trials investigating immune checkpoint blockade (PD-1 or its ligand PD-L1) in advanced clear-cell renal cell carcinoma (RCC) have recently become available. The CheckMate 9ER trial demonstrated an improved progression-free survival (PFS) and overall survival (OS) benefit for the combination of cabozantinib plus nivolumab. A Keynote-426 update demonstrated an ongoing OS benefit for pembrolizumab plus axitinib in the intention-to-treat population, with a PFS benefit seen across all International Metastatic Database Consortium (IMDC) subgroups, while an update of CheckMate 214 confirmed the long-term benefit of ipilimumab plus nivolumab in IMDC intermediate and poor risk patients. The RCC Guidelines Panel continues to recommend these tyrosine kinase inhibitors + immunotherapy (IO) combination across IMDC risk groups in advanced first-line RCC and dual immunotherapy of ipilimumab and nivolumab in IMDC intermediate and poor risk. PATIENT SUMMARY: New data from trials of immune checkpoint inhibitors for advanced kidney cancer confirm a survival benefit with the combination of cabozantinib plus nivolumab and pembrolizumab plus axitinib and ipilimumab plus nivolumab. These combination therapies are recommended as first-line treatment for advanced kidney cancer.
Authors: Jacob J Adashek; Joshua J Breunig; Edwin Posadas; Neil A Bhowmick; Leigh Ellis; Stephen J Freedland; Hyung Kim; Robert Figlin; Jun Gong Journal: Drugs Date: 2022-02-17 Impact factor: 9.546