Dr. Pal on Developments in Frontline Treatments for Patients With mRCC

Sumanta Kumar Pal, MD, a medical oncologist at City of Hope, discusses developments made in frontline treatment for patients with metastatic renal cell carcinoma (mRCC).

Many therapeutic developments have been made in the frontline treatment of patients with mRCC, explains Pal, including the introduction of combinations, such as nivolumab (Opidivo) and ipilimumab (Yervoy), bevacizumab (Avastin) and atezolizumab (Tecentriq), and axitinib (Inlyta) and avelumab (Bavencio). These combinations have demonstrated the utility of pairing VEGF and immunotherapy agents, notes Pal.

The combination of nivolumab and ipilimumab particularly garnered a lot of excitement in the field, following the results of the CheckMate-214 trial. However, the regimen is not suitable for every patient with mRCC. Based on the results of the trial, it was shown that patients with good-risk disease by IMDC classification fare better with TKIs over the combination. Moreover, a patient with an autoimmune condition may be better managed with a TKI, such as cabozantinib (Cabometyx), Pal concludes.