Dr. Powles on Potential With Durvalumab in Papillary RCC

Thomas Powles, MBBS, MRCP, MD, director, Barts Cancer Institute, discusses the use of durvalumab (Imfinzi) in combination with a MET inhibitor in the treatment of patients with papillary renal cancer.

In the CALYPSO trial, presented at the 2019 Genitourinary Cancers Symposium, the PD-L1 inhibitor durvalumab was combined with savolitinib. Preliminary data has suggested that PD-L1/PD-1 has activity in patients with papillary renal cancer and investigators knew from previous savolitinib studies that MET, as a target, also has potential activity in this space. Therefore, the hope was that by combining these agents, researchers would achieve control of the disease in an area of unmet need, explained Powles.

In the single-arm phase I/II study, the response rate was 27% with the combination, which is quite high compared with previous experimental arms like sunitinib (Sutent), adds Powles. Although researchers initially did not look at biomarker-driven disease, Powles says that patients with PD-L1 expression >30% seemed to do better with the treatment, whereas MET did not seem to be predictive of response. What these findings suggest, he adds, is that a lot of the activity is probably being driven by durvalumab and savolitinib is enhancing these responses.

Powles concludes that researchers can create better outcomes for patients with papillary renal cancer by being a bit smarter in their treatment approach than they have been in the past. Originally, physicians were using VEGF TKIs because those agents are used in kidney cancer, but papillary renal cancer is not driven by VEGF. <<< 2019 Genitourinary Cancers Symposium