Optimizing Treatment in Renal Cell Carcinoma

In a phase III study, the PD-1 inhibitor nivolumab reduced the risk of death by 27% versus everolimus in patients with advanced renal cell carcinoma (RCC), improving overall survival by 5.4 months. These patients may achieve durable remission of their disease with a prolonged benefit that persists after the drug is discontinued, notes David F. McDermott, MD. The all-grade adverse event rates were comparable between the two arms at 79% in the nivolumab arm and 88% in the everolimus group.

Based on the benefits seen, McDermott is optimistic that a therapy will be approved within the next 6 months. However, work will still need to be done to identify a population of patients who are likely to respond. Additionally, he remains unsure about whether these agents will be applicable on a global level.

Clinical studies should continue to focus on identifying patients who will benefit long-term, says Eric Jonasch, MD. One area of interest is the incorporation of angiogenic therapies with immunotherapies. Properly designed clinical trials geared toward answering these questions are essential to future improvements in RCC. Emphasizing the need to find predictors of response, Thomas Hutson, DO, PharmD, adds that newer agents in development are quite effective but not generalizable.