Dr. Motzer on Nivolumab Versus Everolimus in Renal Call Carcinoma

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Robert J. Motzer, MD, attending physician, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, and professor of Medicine, Weill Medical College, Cornell University, discusses the FDA approval of nivolumab (Opdivo) versus everolimus (Afinitor) for patients with advanced renal cell carcinoma (RCC).

Nivolumab was studied in a pivotal phase III trial for patients who had progressed on drugs like sunitinib (Sutent) and pazopanib (Votrient). The primary endpoint was overall survival (OS), which was reached, showing an OS benefit for nivolumab compared with everolimus, establishing it as a new standard of care.

Nivolumab had a higher response rate than everolimus, many of the responses being durable, with a median rate being 12 months. There was no improvement in progression-free survival, Motzer explains, which could be due to pseudo progression—when the tumor gets larger—or the mechanism of immunotherapy could be different then VEGF-targeted therapies, leading to delayed responses.