Dr. Bupathi on First-Line Treatment Options for Clear Cell RCC

Manojkumar Bupathi, MD, MS, medical oncologist, Rocky Mountain Cancer Centers, discusses the improvement in first-line treatment options for patients with clear cell renal cell carcinoma (RCC).

Three studies have demonstrated the efficacy of novel treatment options for patients with clear cell RCC in the first-line setting compared with traditional drugs like (Sutent) or pazopanib (Votrient), according to Bupathi. 

For example, the phase 3 CheckMate-9ER trial (NCT03141177) enrolled patients with previously untreated, advanced or metastatic RCC, and randomized them to receive either cabozantinib (Cabometyx) plus nivolumab (Opdivo) or sunitinib. Additionally, the phase 2 CABOSUN trial (NCT01835158) compared the use of cabozantinib vs sunitinib in patients with locally advanced or metastatic disease. Finally, the phase 3 CheckMate-214 trial (NCT02231749) enrolled patients with intermediate or poor-risk disease and compared the use of a doublet immunotherapy regimen comprised of nivolumab plus ipilimumab (Yervoy) vs sunitinib.

When navigating among these available options, it is important to consider risk stratification, possible associated toxicities, and whether a patient has symptomatic disease, Bupathi explains. Furthermore, comorbidities can help guide clinical decisions in this population, Bupathi concludes.