Dr. Sonpavde on Combining VEGF/PD-1 Inhibitors in Metastatic Urothelial Carcinoma

Guru P. Sonpavde, MD, director, Bladder Cancer, and physician, Dana-Farber Cancer Institute, discusses the utility of combining anti-VEGF and anti–PD-1 agents in metastatic urothelial carcinoma.

The combination of cabozantinib (Cabometyx) and nivolumab (Opdivo) with or without ipilimumab (Yervoy) has elicited intriguing data in metastatic urothelial carcinoma, Sonpavde says. Moreover, the triplet is being evaluated in an ongoing phase 2 trial to further evaluate its efficacy.

Another combination, lenvatinib (Lenvima) and pembrolizumab (Keytruda), is being investigated in the ongoing phase 3 LEAP-011 trial in patients with PD-L1–positive, cisplatin-ineligible or platinum-ineligible disease, explains Sonpavde.

Finally, the investigational TYRO3, AXL and MER (TAM) inhibitor sitravatinib (MGCD516), which also inhibits VEGF, in combination with nivolumab has demonstrated early efficacy in patients who progress on checkpoint inhibitors, Sonpavde says.

Dual inhibition of VEGF and PD-1/PD-L1 could lead to regulatory approvals in the future pending positive findings from larger phase 3 trials, Sonpavde concludes.