Dr. Rini on Choosing Between IO/IO or IO/TKI Combinations in mRCC

Brian I. Rini, MD, professor of medicine and inaugural chief of Clinical Trials at Vanderbilt-Ingram Cancer Center, discusses choosing between combinations of dual immunotherapy and immunotherapy/VEGF TKIs in metastatic renal cell carcinoma (mRCC).

The decision of whether a patient should receive combination therapy with immunotherapy or immunotherapy plus a TKI continues to be debated in mRCC, says Rini.

Although treatment selection is complicated, having more options available is beneficial because some patients respond to and tolerate regimens differently, Rini adds.

Currently, immunotherapy combinations, such as nivolumab (Opdivo) plus ipilimumab (Yervoy), have more mature data that demonstrate durability, Rini explains. Conversely, immunotherapy plus TKI regimens have shown higher response rates, more tumor shrinkage, and more up-front disease control vs immunotherapy combinations. However, these data are not yet mature enough to determine whether responses will be durable.

Ultimately, an argument could be made in favor of either regimen. Additional data are needed to better inform optimal treatment decisions, concludes Rini.