Dr. Jonasch on Molecular Understanding of Clear Cell RCC

Eric Jonasch, MD, professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the molecular understanding of clear cell renal cell carcinoma (RCC).

As far as molecular classification schemes go, the field of RCC is behind that of other malignancies, explains Jonasch. Researchers are aware of key mutations including PBRM1, BAP1, and SETD2, but their influence on the surrounding microenvironment as well as their impact on response to therapy is unknown. This is a critical element to understand as more therapies come to market.

Secondly, investigators need to think differently about clinical trial endpoints, adds Jonasch. With the combination of ipilimumab (Yervoy) and nivolumab (Opdivo), up to 9% of patients are achieving a complete response (CR), and up to 16% of patients with intermediate- and poor-risk disease as well as those who are PD-L1—positive are achieving a CR. This suggests that CR should take greater precedence in clinical trials as a way to assess for efficacy, he explains.