Dr. Gupta on Impact of Pembrolizumab Plus Bevacizumab Findings in RCC

Shilpa Gupta, MD, assistant professor of medicine, Hematology/Oncology and Transplantation Division, University of Minnesota, discusses the impact of the phase Ib/II results of pembrolizumab (Keytruda) plus bevacizumab (Avastin) in patients with metastatic renal cell carcinoma (RCC).

Findings from a phase Ib and a phase II study of pembrolizumab with bevacizumab in patients with metastatic RCC showed that the 200 mg dose of pembrolizumab and the 12 mg/kg dose of bevacizumab given every 3 weeks is active and safe. Even though there are currently other combination studies of immunotherapy and VEGF blockade, Gupta says that this combination does not require patients to express PD-L1 ≥ 1%. Gupta says that the results from this study call into question the importance of PD-L1 expression in regard to overall response rate to immunotherapy in RCC.

The rationale for the combination of pembrolizumab and bevacizumab is that the angiogenesis controls the trafficking of cells, and synergy has been demonstrated between anti-VEGF therapies and checkpoint inhibitors in other tumor types. Additionally, it is a tolerable combination for these patients.