Dr Gopal on Future Research Directions in Non-ccRCC

Nikhil A. Gopal, MD, assistant professor, urology, assistant professor, College of Medicine - Memphis, Department of Urology, The University of Tennessee Health Science Center, discusses future research directions for immuno-oncology (IO)/TKI combinations across renal cell carcinoma histologies.

In frontline metastatic clear cell renal cell carcinoma (ccRCC), there is currently a robust selection of agents that have significantly improved patient outcomes. Accordingly, this offers oncologists a range of effective treatment options to choose from, Gopal begins. Looking ahead, the focus of research is shifting towards developing novel treatment strategies in non-clear cell RCC, Gopal states. There is particular interest in papillary RCC, which is the second most common subtype of kidney cancer, he adds. Although single-agent therapies such as cabozantinib (Cabometyx) have demonstrated promising results, combination regimens may hold greater potential for optimizing outcomes in this patient population, Gopal explains.

There is currently a lack of data supporting the use of combination therapies in non-ccRCC, Gopal continues. However, ongoing trials are investigating immune checkpoint inhibitor combinations for this population, and are expected to provide valuable insights into the benefit of these regimens, he states. Understanding the efficacy and safety of these combinations is crucial for advancing treatment paradigms beyond ccRCC, Gopal emphasizes.

Notably, patients with sarcomatoid histology have demonstrated favorable responses when treated with immunotherapy, Gopal says, adding that this underscores the importance of exploring novel approaches that encompass variant RCC histologies in clinical trials. In the coming years, Gopal expresses that he hopes to witness a transformation in the focus of RCC research, with a renewed commitment to addressing key questions and refining treatment strategies specifically tailored to non-ccRCC subtypes.

As the field progresses beyond ccRCC, advancements in IO combinations and tailored therapies in non-ccRCC variants hold promise for improving outcomes and expanding treatment options for patients with variant RCC histologies, Gopal concludes.