Dr. McGregor the Potential Utility of Cabozantinib/Nivolumab in Advanced RCC

Bradley McGregor, MD, clinical director, Lank Center for Genitourinary Oncology, senior physician, Dana-Farber Cancer Institute, and instructor of medicine, Harvard Medical School, discusses the potential utility of the combination of cabozantinib (Cabometyx) and nivolumab (Opdivo) in advanced renal cell carcinoma (RCC).

On October 19, 2020, the FDA granted a priority review designation to cabozantinib plus nivolumab for the treatment of patients with advanced RCC based on findings from the phase 3 CheckMate-9ER trial. The trial showed that the combination induced in a 49% reduction in the risk of progression or death compared with sunitinib (Sutent) when used as a frontline treatment in patients with advanced RCC.

Notably, the benefits in progression-free survival, overall survival, and overall response rate with cabozantinib/nivolumab vs sunitinib was observed across key subgroups, including International Metastatic RCC Database Consortium subgroups.

Additionally, the safety data showed that the regimen was well tolerated, says McGregor. Moreover, patients reported significantly improved quality of life with cabozantinib/nivolumab vs sunitinib.

The combination could represent another standard of care option for the frontline treatment of patients with advanced RCC, says McGregor.

Should the regimen receive FDA approval, treatment selection between cabozantinib/nivolumab, pembrolizumab (Keytruda)/axitinib (Inlyta), axitinib/avelumab (Bavencio), and nivolumab/ipilimumab (Yervoy) will be determined by toxicity, patient preference, and length of study follow-up, concludes McGregor.