Dr. Vaishampayan on the Expanding Role of TKI/Immunotherapy Combinations in mRCC

Ulka N. Vaishampayan, MBBS, FAB, director of the Phase I program at the Rogel Cancer Center and a professor of internal medicine at the University of Michigan, discusses the expanding role of TKI/immunotherapy combinations in metastatic renal cell carcinoma (mRCC). 

Several ​VEGF TKI/immunotherapy combinations have established efficacy in metastatic RCC, says Vaishampayan.

Currently, axitinib (Inlyta) plus pembrolizumab (Keytruda) and axitinib plus avelumab (Bavencio) are approved for the treatment of patients with mRCC, says Vaishampayan. Both regimens have shown significant improvement​s in overall response rate (ORR) and progression-free survival (PFS) compared with sunitinib (Sutent).

Additionally, findings from the phase 3 KEYNOTE-426 trial demonstrated an overall survival (OS) benefit with the combination of axitinib and pembrolizumab​.

Notably, results from the phase 3 CheckMate​-9ER trial, which were presented during the 2020 ESMO Virtual Congress, demonstrated superiority with the combination of nivolumab (Opdivo) and cabozantinib (Cabometyx) ​vs sunitinib in terms of PFS, OS and ORR ​for the first-line treatment of patients with ​advanced RCC. 

In fact, the median PFS was doubled from 8​.3 months with sunitinib to 16.6 months with the combination, Vaishampayan concludes.