Dr. Beckermann on Sequencing Strategies in mRCC

Kathryn E. Beckermann, MD, PhD, instructor of medicine, Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, discusses sequencing strategies in metastatic renal cell carcinoma (mRCC).

There is no optimal sequencing strategy, says Beckermann. As such, the phase III PDIGREE trial is evaluating the value of immunotherapy with nivolumab (Opdivo) and ipilimumab (Yervoy) followed by nivolumab alone, or in combination with cabozantinib (Cabometyx). As more is uncovered about mechanisms of resistance, the field will better understand what the optimal sequencing should be, says Beckermann.

Additional trials are investigating the value of sequential therapy with CTLA-4 inhibition in patients who do not respond to PD-1 inhibition alone. Notably, there is some evidence to suggest that giving a PD-1 inhibitor plus a CTLA-4 inhibitor following single-agent PD-1 inhibition could be of benefit. Though, more data are needed, concludes Beckermann.