Dr. McKay on the Rationale for Triplet Frontline Therapy in RCC

Rana R. McKay, MD, associate professor of medicine, Department of Medicine, UC San Diego School of Medicine, discusses the pros and cons of utilizing triplet therapy in the frontline treatment of patients with renal cell carcinoma (RCC).

The current standard of care in the frontline setting for patients with RCC is immune-oncology (IO)–based doublet therapy, either with IO plus a VEGF inhibitor or an IO/IO combination, McKay says. IO/VEGF doublet therapy is associated with short-term efficacy, according to McKay, who stresses that data for long-term durability is still unknown. For that IO/IO combination of nivolumab (Opdivo) plus ipilimumab (Yervoy), the progressive disease rate is higher in the short term, but the combination presents the potential for long-term durability, McKay says.

Given the potential downside of doublet therapy, triplet therapy could increase short- and long-term efficacy, McKay continues. However, adding another drug to a patient’s regimen always carries the risk of increased toxicity, McKay explains. The toxicity risk vs the efficacy benefit of triplet therapy is at the center of the debate between doublet and triplet therapy in RCC, McKay concludes.