Rohit Kumar, MD, discusses the benefits of combining immunotherapy agents with each other or with TKIs in patients with renal cell carcinoma and the unmet needs that remain for patients with RCC who do not respond to immunotherapy.
Rohit Kumar, MD, assistant professor, the Department of Medicine, the University of Louisville, discusses the benefits of combining immunotherapy agents with each other or with TKIs in patients with renal cell carcinoma (RCC) and the unmet needs that remain for patients with RCC who do not respond to immunotherapy.
TKIs are an established therapeutic option for patients with RCC, and adding immunotherapy to the armamentarium has changed the RCC treatment landscape, Kumar says. Patients with RCC who receive immunotherapy, even those with stage IV disease, are experiencing years-long progression-free survival, as well as overall survival of up to 5 years, meaning some of these patients are likely cured, Kumar explains. The addition of immunotherapy agents to TKIs or to other immunotherapy agents is a step forward for RCC treatment, Kumar highlights.
Many patients with clear cell RCC are responding to immunotherapy doublets, even those with advanced disease, Kumar notes. However, there is still an unmet need for treatment options after patients have progressed on TKI/immunotherapy or immunotherapy/immunotherapy combinations, Kumar says. In the frontline setting, immunotherapy/immunotherapy combinations have an 18% primary progression rate, meaning 18% of patients progress while on this treatment, Kumar explains. Since an unspecified subgroup of patients with RCC does not respond to immunotherapy, more research to develop more effective options is crucial, Kumar emphasizes.
Ongoing trials are investigating genetics and mutation genomics to determine which patients with RCC do not respond to immunotherapy and why, Kumar notes. Research is evaluating whether this primary progression on immunotherapy can be predicted, and whether other treatment options, such as triplet therapies or novel agents, may disproportionately benefit a subgroup of patients, Kumar says. Successful outcomes from this research may fulfill this large unmet need in patients with RCC who progress on immunotherapy, Kumar concludes.