Dr. Zhang on the PDIGREE Trial Examining Nivolumab/Ipilimumab Plus Cabozantinib in Metastatic RCC

Tian Zhang, MD, an assistant professor of medicine at Duke University School of Medicine, and member, Duke Cancer Institute, discusses the goal of the ongoing PDIGREE trial examining nivolumab (Opdivo) and ipilimumab (Yervoy) plus cabozantinib (Cabometyx) in patients with metastatic untreated renal cell cancer (RCC).

In the ongoing, adaptive phase 3 trial, the population of patients with intermediate- to poor-risk metastatic kidney cancer were given a combination of ipilimumab and nivolumab up front for up to 4 cycles, Zhang says. Based on their responses at 3 months, patients were then randomized to either the CheckMate-214 regimen of nivolumab alone, or nivolumab in combination with cabozantinib, which has shown efficacy in the CheckMate-9ER study, Zhang explains.

The goals of the PDIGREE trial are to increase overall survival compared with the historic control from CheckMate-214, as well as improve complete response rates among patients, Zhang says. A key secondary end point of the trial aims to improve 1-year complete response rates, indicating which patients can stop therapy. PDIGREE is one of the first trials to test prospective immunotherapy discontinuation in kidney cancer, Zhang concludes.