Dr. Stadler on the Therapeutic Landscape of RCC

Walter M. Stadler, MD, Fred C. Buffett Professor of Medicine and Surgery, chief of the Section of Hematology/Oncology, and director of the Genitourinary Program at the University of Chicago Medicine, discusses the therapeutic landscape of renal cell carcinoma (RCC).

In the last 10 years or so, physicians have relied on VEGFR-targeted therapies in RCC, including pazopanib (Votrient), sunitinib (Sutent), and axitinib (Inlyta). Now, physicians are moving into an era of immunotherapy, which includes nivolumab (Opdivo), pembrolizumab (Keytruda), ipilimumab (Yervoy), and avelumab (Bavencio), enabling researchers to look at combination approaches.

Part of the rationale of exploring combinations of VEGF and immunotherapy agents is their accessibility, says Stadler. However, there is a scientific rationale for their use in combination as well. For example, some of the VEGF pathways have been shown to be immunosuppressive and may induce immunosuppressive properties, says Stadler. Some of the combinations that have been shown to be effective to date include axitinib and avelumab, axitinib and pembrolizumab, and atezolizumab and bevacizumab (Avastin).