Dr. Figlin on Toxicity Profile of Immunotherapy/VEGF TKI Combinations in RCC

Robert A. Figlin, MD
Published: Wednesday, May 08, 2019



Robert A. Figlin, MD, Steven Spielberg Family Chair in Hematology Oncology, director, Division of Hematology/Oncology, deputy director, Integrated Oncology Service Line, and professor of Biomedical Sciences, Medicine, at Cedars-Sinai Medical Center, discusses the toxicity profiles of combinations of immune checkpoint inhibitors and VEGF TKIs in renal cell carcinoma (RCC), as well as research being done to validate potential biomarkers in the space.

The toxicity profile seen with combinations of immunotherapy and VEGF TKIs is in line with expectations, says Figlin. There are separate immune-related adverse events (AEs) with the immunotherapy agent, plus hypertension, hand-foot syndrome, diarrhea, fatigue, and loss of appetite with the VEGF TKI. Encouragingly, there have been no reports of synergistic toxicities with these agents when combined, he adds. With the proper knowledge of immune-related AEs and their time course, as well as those of TKIs, these toxicities can be well managed.

Although work is being done to prospectively validate an array of potential biomarkers, including angiogenic profiles, immunotherapy profiles, or PD-L1 staining, none currently hold any applicability to the management of patients with RCC, concludes Figlin.
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Robert A. Figlin, MD, Steven Spielberg Family Chair in Hematology Oncology, director, Division of Hematology/Oncology, deputy director, Integrated Oncology Service Line, and professor of Biomedical Sciences, Medicine, at Cedars-Sinai Medical Center, discusses the toxicity profiles of combinations of immune checkpoint inhibitors and VEGF TKIs in renal cell carcinoma (RCC), as well as research being done to validate potential biomarkers in the space.

The toxicity profile seen with combinations of immunotherapy and VEGF TKIs is in line with expectations, says Figlin. There are separate immune-related adverse events (AEs) with the immunotherapy agent, plus hypertension, hand-foot syndrome, diarrhea, fatigue, and loss of appetite with the VEGF TKI. Encouragingly, there have been no reports of synergistic toxicities with these agents when combined, he adds. With the proper knowledge of immune-related AEs and their time course, as well as those of TKIs, these toxicities can be well managed.

Although work is being done to prospectively validate an array of potential biomarkers, including angiogenic profiles, immunotherapy profiles, or PD-L1 staining, none currently hold any applicability to the management of patients with RCC, concludes Figlin.



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