Dr. Figlin on Novel Combinations in Kidney Cancer Treatment

Robert A. Figlin, MD, Steven Spielberg Family Chair in Hematology Oncology, director, Division of Hematology/Oncology, deputy director, Integrated Oncology Service Line, and professor of Biomedical Sciences and Medicine at Cedars-Sinai Medical Center, discusses novel combinations in the treatment of patients with kidney cancer.

The good news is that there are now combination regimens, such as nivolumab (Opdivo) and ipilimumab (Yervoy), pembrolizumab (Keytruda) plus axitinib (Inlyta), and avelumab (Bavencio) plus axitinib, all of which have demonstrated an improvement over the previous standard of care, sunitinib (Sutent), says Figlin.

These combinations are also tolerable and the quality of life is maintained for patients. However, these combinations have not yet been compared with each other, which makes the treatment choice difficult for physicians, Figlin adds.

Not all patients are eligible for immunotherapy approaches due to complications, such as comorbid disease, requirement for certain treatments that are not cancer related, and brain metastases that may require steroids or radiation. Although, there may be agents, such as cabozantinib (Cabometyx), for patients in those settings. Physicians are always balancing the role of immunotherapy versus the role of immunotherapy and TKIs versus selected patients receiving a TKI, concludes Figlin.