Dr Merchán on the Future Treatment of Advanced RCC

Jaime R. Merchán, MD, associate professor, medicine, Department of Medicine, Division of Medical Oncology, co-leader, Translational and Clinical Oncology Research Program, director, Phase 1 Clinical Trials Program, Sylvester Comprehensive Cancer Center, the University of Miami Health System, discusses the future treatment of patients with advanced renal cell carcinoma (RCC).

In the realm of RCC research, the direction of future investigations is poised toward a biomarker-driven approach, particularly in the context of immuno-oncology (IO) and TKI combinations, Merchán begins. This vision entails the use of biomarker-driven clinical trials to stratify patients based on specific genomic or transcriptomic signatures that could predict efficacy in response to various treatment combinations, according to Merchán. Recent advancements in transcriptomic profiling have unveiled promising signatures that hold potential in guiding treatment selection, he explains.

The strategy involves identifying patients who harbor certain biomarkers that make them more likely to respond favorably to IO/TKI combinations. For instance, patients with distinct transcriptomic signatures indicative of responsiveness to IO/TKIs may be directed toward treatment with those agents, whereas patients exhibiting signatures indicating a stronger response to dual immunotherapies may be assigned accordingly, Merchán reports. This tailored approach aims to optimize treatment outcomes by matching patients with therapies that align with their molecular profiles, Merchán emphasizes.

RCC management will transition toward a biomarker-driven paradigm, as evidenced by the activation of several ongoing clinical trials designed to assess the efficacy and feasibility of these targeted combinations, he elucidates, adding that the results of these trials are eagerly anticipated. The incorporation of biomarker-driven strategies represents a progressive shift toward personalized medicine within RCC management, Merchán notes. The ongoing clinical trials exploring IO/TKI and IO/IO combinations are poised to provide critical insights into the efficacy and applicability of these tailored approaches, heralding a new era of precision medicine in the management of RCC, Merchán concludes.