Dr. McGregor on Frontline Regimens in Advanced RCC

Bradley McGregor, MD, clinical director, Lank Center for Genitourinary Oncology, senior physician, Dana-Farber Cancer Institute, and instructor of medicine, Harvard Medical School, discusses frontline treatment regimens in advanced renal cell carcinoma (RCC).

It can be difficult to broach frontline treatment now that there are several combination regimens from which to choose, says McGregor. If a patient has a pending crisis and is in dire need of a response, McGregor recommends opting for a combination approach with immunotherapy and a VEGF TKI. These symptomatic patients who may have lung or liver metastases are more likely to have an immediate response to an immunotherapy/VEGF TKI combination rather than the combination of ipilimumab (Yervoy) and nivolumab (Opdivo), he says.

On the other hand, a younger patient with minimal burden of disease might prefer the combination of nivolumab and ipilimumab, as it offers a chance for treatment discontinuation. According to data from the phase III CheckMate-214 trial, a subset of patients who received the immunotherapy combination were able to stop treatment and maintain their complete response, McGregor concludes.