Dr. McGregor on New Combinations With Immunotherapy in RCC

Bradley McGregor, MD
Published: Tuesday, May 22, 2018



Bradley McGregor, MD, physician, Genitourinary Oncology program, Dana-Farber Cancer Institute, instructor of medicine, Harvard Medical School, discusses new combinations with immunotherapy in renal cell carcinoma (RCC).

In addition to the 2 recent phase III trials, CheckMate-214 and IMmotion151, there are emerging combinations with immunotherapy showing promise in RCC. There are currently clinical trials of immunotherapy agents in combination with tyrosine kinase inhibitors, says McGregor. These trials include pembrolizumab (Keytruda) plus lenvatinib (Lenvima), axitinib (Inlyta) plus avelumab (Bavencio), and axitinib plus pembrolizumab.

McGregor says that Dana-Farber Cancer Institute is participating in the CLEAR trial, which is investigating pembrolizumab with lenvatinib versus lenvatinib with everolimus (Afinitor) versus sunitinib (Sutent). Additionally, there is a phase III study of nivolumab (Opdivo) plus cabozantinib (Cabometyx) versus sunitinib in patients with RCC.

Although these regimens have shown benefit in patients with RCC, McGregor cautions that combination therapy comes with increased toxicity. For example, about 60% of patients who take ipilimumab (Yervoy) plus nivolumab require steroids.
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Bradley McGregor, MD, physician, Genitourinary Oncology program, Dana-Farber Cancer Institute, instructor of medicine, Harvard Medical School, discusses new combinations with immunotherapy in renal cell carcinoma (RCC).

In addition to the 2 recent phase III trials, CheckMate-214 and IMmotion151, there are emerging combinations with immunotherapy showing promise in RCC. There are currently clinical trials of immunotherapy agents in combination with tyrosine kinase inhibitors, says McGregor. These trials include pembrolizumab (Keytruda) plus lenvatinib (Lenvima), axitinib (Inlyta) plus avelumab (Bavencio), and axitinib plus pembrolizumab.

McGregor says that Dana-Farber Cancer Institute is participating in the CLEAR trial, which is investigating pembrolizumab with lenvatinib versus lenvatinib with everolimus (Afinitor) versus sunitinib (Sutent). Additionally, there is a phase III study of nivolumab (Opdivo) plus cabozantinib (Cabometyx) versus sunitinib in patients with RCC.

Although these regimens have shown benefit in patients with RCC, McGregor cautions that combination therapy comes with increased toxicity. For example, about 60% of patients who take ipilimumab (Yervoy) plus nivolumab require steroids.



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