Dr. Agarwal Discusses Results of KEYNOTE-426 in mRCC

Neeraj Agarwal, MD, associate professor, Division of Oncology, Department of Medicine, University of Utah School of Medicine, Huntsman Cancer Institute, discusses findings from the KEYNOTE-426 study in patients with metastatic renal cell carcinoma (mRCC).

For the phase III study presented at the 2019 Genitourinary Cancers Symposium, investigators randomized patients to receive either pembrolizumab (Keytruda) plus axitinib (Inlyta) or sunitinib (Sutent). Progression-free survival was clearly superior with the immunotherapy/TKI combination compared with the standard TKI alone, Agarwal says. Objective response rates were 59% with the combination versus 36% with sunitinib. Further, the checkpoint inhibitor and TKI combination significantly increased overall survival in these patients.

Based on this data, pembrolizumab plus axitinib seems to be a promising new option for patients with mRCC, Agarwal notes, although the complete response rates with the combination were lower than those seen the FDA-approved combination of nivolumab (Opdivo) and ipilimumab (Yervoy)—5% versus 11% in favor of the PD-1/CTLA-4 inhibitor combination. Agarwal says this is the only qualm he has with pembrolizumab plus axitinib.