Non–Clear Cell RCC: Clinical Rationale Behind Therapy

EP: 1.Patient Profile 1: Intermediate/Poor Risk RCC Treated With Ipilimumab-Nivolumab

EP: 2.I/O–I/O Therapy in Intermediate/Poor Risk RCC: Toxicity and Duration of Response

EP: 3.Triplet Therapy Approaches for Intermediate/Poor Risk RCC

EP: 4.Patient Profile 2: Favorable-Risk RCC Treated With Lenvatinib-Pembrolizumab

EP: 5.Risk Stratification and Factors in Selecting Therapy in RCC

EP: 6.Lenvatinib/Pembrolizumab in RCC: Dosing and Adverse Event Management

EP: 7.Patient Profile 3: RCC Treated With Adjuvant Pembrolizumab

EP: 8.Adjuvant and Neoadjuvant Therapies Under Evaluation for Renal Cell Carcinoma

EP: 9.Clear Cell RCC: Testing Recommendations and Familial Risk

EP: 10.Patient Profile 4: Non–Clear Cell RCC Treated With Cabozantinib-Nivolumab

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EP: 11.Non–Clear Cell RCC: Clinical Rationale Behind Therapy

EP: 12.Renal Cell Carcinoma: Future Directions in Care

Transcript:

Robert J. Motzer, MD: Chung, you’ve led our efforts in therapeutics for non–clear cell RCC [renal cell carcinoma]. Recently you presented these exciting data for cabozantinib plus nivolumab, which this patient is being treated with. How do you see this entity of non–clear cell in terms of different groups of patients or histologies. What’s been your experience with this cabozantinib-nivolumab regimen?

Chung-Han Lee, MD:Historically speaking, this non–clear cell entity has always been this grab bag of histologies. Clear cell kidney cancer is the most common histology, and non–clear cell just happens to be everything else. From clinical trial eligibilities, from our standpoint, most clinical trials that have been done have focused on clear cell. The regimens that are available for clear cell have activity within the non–clear cell cohorts. However, those efficacy rates tend to be lower. We led a study at Memorial [Sloan Kettering Cancer Center] looking at the role of cabozantinib plus nivolumab, to estimate the efficacy of this regimen. It made a lot of sense from a clinical aspect because cabozantinib has demonstrated a lot of activity within the papillary kidney cancer group, which is the most common of the non–clear cell cohort, and cabozantinib-nivolumab also shows high levels of activity within clear cell.

When we decided to do this study within non–clear cell kidney cancer, we observed a fairly high objective response rate: about 48% over a patient population of about 40 people. This led to the protocol being subsequently expanded to 80 so that we can get a better estimate of this regimen. There’s a lot of very encouraging news for non–clear cell. We need to make additional efforts in better tailoring and stratifying based off the various histologies within that non–clear cell cohort, so we can help this very unmet population.

Transcript edited for clarity.