Dr. Pal on Preoperative Immunotherapy in Patients With RCC

Sumanta Kumar Pal, MD, medical oncologist, assistant clinical professor, Department of Medical Oncology and Therapeutics Research, co-director, Kidney Cancer Program, City of Hope, discusses the potential with immunotherapy in the preoperative setting for patients with renal cell carcinoma (RCC).

There are 2 clinical trials in this space, one of which is the phase III trial of atezolizumab (Tecentriq) in these patients, Pal explains, though this is an adjuvant trial exploring the PD-L1 inhibitor in patients who are at high risk for developing metastases following nephrectomy (NCT03024996).

The other study is through the Eastern Cooperative Oncology Group (ECOG), called the PROSPER trial, which is investigating a short duration of nivolumab (Opdivo) followed by surgery, and then followed by extended treatment with nivolumab, compared with observation.

Both studies have merits, Pal says. The ECOG study, however, could face obstacles due to low accrual. It is challenging to facilitate the neoadjuvant window of therapy, he says, in addition to the theoretical risk of progression.