David McDermott, MD
Immunotherapy has made an incredible impact on the treatment of patients with metastatic renal cell carcinoma (RCC), and is now beginning to make waves in other settings of the disease.
during the meeting, McDermott shared some of the successes with immunotherapy in RCC and gave his insight on the future treatment of these patients.
OncLive: Can you please provide an overview of your talk?
: There are a lot of new interesting data in both kidney cancer and bladder cancer for immune-based therapies. We have established that single-agent immune checkpoint blockade with either PD-1/PD-L1 is active in both diseases, and now people are looking at other questions, such as, “How can you overcome resistance to treatment by adding new agents in?” For example, does CTLA-4 in addition to PD-1 add benefit? Does blocking VEGF in addition to blocking PD-1/PD-L1 add benefit? Importantly, how can we figure out which patients should get which combination? This is because most combinations add adverse events and costs, so it is up to us to try to identify who should get which new combination therapy ahead of time.
Combinations have been very successful in the metastatic setting. Could you comment on some of these combinations?
The newest and probably most exciting data come from the CheckMate-214 study, which looked at the combination of PD-1 blockade with nivolumab, and CTLA-4 blockade with ipilimumab (Yervoy), which is FDA approved in melanoma. However, this trial established its role in kidney cancer, particularly in the intermediate- and poor-risk population of patients based on clinical criteria. In that subgroup, patients who received the combination did better in terms of response, had a longer progression-free survival (PFS), and significantly longer overall survival. There was a higher complete response rate at approximately 9%, which is very exciting.
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