Dr Uzzo on a Biomarker Analysis of the IMmotion010 Trial in RCC

Robert Uzzo, MD, MBA, FACS, G. Willing “Wing” Pepper Chair in Cancer Research, president, chief executive officer, Fox Chase Cancer Center; executive vice president, Cancer Services, Temple University Health System; senior associate dean, Clinical Cancer Research, Lewis Katz School of Medicine, Temple University, discusses 

 of the phase 3 IMmotion010 study (NCT03024996) investigating adjuvant atezolizumab (Tecentriq) in patients with renal cell carcinoma (RCC). Findings from this analysis were presented at the 

IMmotion010 was a major adjuvant study in kidney cancer, where patients were randomly assigned to receive either atezolizumab for 1 year or placebo for the same duration, Uzzo begins. The objective was to reduce the risk of cancer recurrence. The study included patients with intermediate- or high-risk kidney cancer, specifically those with grade 4, T2, or more severe disease, including metastatic disease that could be surgically resected, he explains. Importantly, all patients underwent complete resection of their tumors before random assignment, Uzzo adds.

The main aim of this research was to determine whether immediate adjuvant immunotherapy could lower the recurrence risk and improve disease-free survival (DFS) in this population vs placebo, Uzzo reports. Unfortunately, the study results indicated that adding atezolizumab did not enhance DFS. However, the study included a substantial number of serum samples, he says. Researchers analyzed these samples, focusing on various expressions of KIM-1 in the plasma, to assess whether KIM-1 could serve as a circulating biomarker for better patient identification, Uzzo explains.

The findings revealed that a high baseline level of KIM-1 was associated with a poorer DFS rate across the overall cohort, Uzzo expands. Specifically, patients with higher KIM-1 levels at baseline tended to experience more frequent recurrences, he says. Additionally, among patients with elevated KIM-1 levels at baseline, those who received atezolizumab had better outcomes compared with those with lower KIM-1 levels, Uzzo concludes. Notably, the subgroup of patients with high pre-operative KIM-1 levels experienced an approximate 28% improvement in DFS when treated with atezolizumab compared with placebo.

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Robert Uzzo, MD, MBA, FACS, discusses a biomarker analysis of the IMmotion010 trial in patients with renal cell carcinoma.


 Robert G. Uzzo, MD, MBA, FACS, chair, Department of Surgical Oncology, G. Willing "Wing" Pepper Chair in Cancer Research, Kidney, Bladder, and Prostate Cancer TRDG member, senior vice president, Physician Services, Fox Chase Cancer Center, and professor of surgery, Temple University Health System, discusses the evolving role of surgery in metastatic kidney cancer.

As a surgeon, Uzzo says that most of his time is spent thinking about the biology of the tumor and if surgery can be used as an intervention to provide therapeutic benefit. Before many systemic therapies were available, surgery was typically the standard of care for patients with kidney cancer, he explains.

New research, such as the phase III CARMENA and SURTIME trials, are exploring whether surgery is beneficial in the upfront setting for patients with metastatic disease or if it may be more effective after systemic therapies are given. After receiving upfront systemic therapy, many patients become good responders with prolonged partial responses, and sometimes complete responses. The question then becomes whether to revisit the surgical option afterward, says Uzzo. Mainly, how can the results of the systemic therapies be consolidated with surgery? Uzzo predicts more research will be exploring this idea further.

Because these patients will require lifelong treatment for their disease, the overall goal is to get them to a place where they can eventually come off of therapy for long periods of time. Although the emerging agents such as HIF inhibitors and other combinations are generating excitement in the space, the role of surgery continues to evolve and play an important role in the care of patients with kidney cancer, he concludes.

Robert G. Uzzo, MD, MBA, FACS, discusses the evolving role of surgery in metastatic kidney cancer.

Robert G. Uzzo, MD, MBA, FACS

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Dr Uzzo on a Biomarker Analysis of the IMmotion010 Trial in RCC

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