Cabozantinib or Nivolumab Plus Ipilimumab as Treatment Options for Renal Cell Carcinoma
A review of data from the CABOSUN and CheckMate-214 trials to determine the use of targeted therapy in metastatic renal cell carcinoma.
|The following article features coverage from the Chemotherapy Foundation Symposium (CFS) in New York, NY. Click here to read more of Cancer Therapy Advisor's conference coverage.|
Previous studies have supported the use of targeted monotherapies with vascular endothelial growth factor tyrosine kinase inhibitors (VEGF-TKI) in the treatment of patients with metastatic renal cell carcinoma (mRCC), according to an oral presentation given at the 35th Annual Chemotherapy Foundation Symposium.1
In the past 10 years, mRCC treatment has primarily depended on VEGF-directed therapies (eg, sunitinib, pazopanib, bevacizumab) with progression-free survival (PFS) rates between 9 to 12 months and median overall survival (OS) between 2 to 2.5 years. Recent studies, however, have demonstrated that there may be new treatment considerations for the frontline setting.
The phase 2 CABOSUN study compared sunitinib with cabozantinib, a multikinase inhibitor that targets VEGF, MET, and AXL in treatment-naive patients with intermediate and poor-risk disease. Patients treated with cabozantinib had significantly superior PFS (8.6 months) as well as a trend toward benefit in OS compared with patients who received sunitinib.
In the phase 3 CheckMate-214 study, previously untreated patients were randomly assigned to receive nivolumab plus ipilimumab or sunitinib. Patients treated with nivolumab and ipilimumab had a significantly superior overall response rate and OS compared with patients treated with sunitinib.
The presenter, Sumanta K. Pal, MD, pointed out that nivolumab and ipilimumab may not be a one-size-fits-all treatment option for patients with mRCC. Patients with low PD-L1 expression did not experience any improvements in outcome compared with sunitinib, but patients with high expression had a marked advantage, suggesting that PD-L1 may be a potential biomarker for this population.
Dr Pal concluded that although there are many developments in the field of mRCC management, various factors such as PD-L1 negative status, biomarkers, and stool microbiomes, warrant further study.
Read more of Cancer Therapy Advisor's coverage of the Chemotherapy Foundation Symposium (CFS) by visiting the conference page.
- Pak SK. Renal cell carcinoma: how should we be using targeted therapy? Oral presentation at: 35th Annual Chemotherapy Foundation Symposium; November 8-10, 2017; New York, NY.