Dr. Harshman on Earlier Use of Immunotherapy in RCC

Lauren C. Harshman, MD, assistant professor of medicine, Harvard Medical School, senior physician, Dana-Farber Cancer Institute, discusses moving immunotherapy earlier in the line of therapy for patients with renal cell carcinoma (RCC).

Harshman says that the next step in the treatment of patients with RCC is moving immunotherapy into earlier lines of treatment. Investigators are currently testing checkpoint inhibitors such as atezolizumab (Tecentriq) and pembrolizumab (Keytruda). In April 2018, the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) was approved by the FDA as a frontline treatment for intermediate- and poor-risk patients with advanced RCC.

The PROSPER study is looking at adjuvant therapy in a novel way, Harshman says. This trial is giving a few doses of PD-1 priming blockade to activate the immune system. Following this, 9 months of adjuvant nivolumab is given to sustain the immune system and work against micrometastatic disease. Harshman explains that when a significant amount of androgen is in place, a T-cell effector army can be built to take out the tumor.