Dr. Hammers on the Future of Immunotherapy in RCC

Hans Hammers, MD, PhD, associate professor, Internal Medicine, UT Southwestern Medical Center, discusses the future of immunotherapy for patients with renal cell carcinoma (RCC).

For patients with recurrent metastatic disease, there are effective chemotherapies to choose from, but that is not the case for patients with RCC, says Hammers. Although, immunotherapy is now moving into the first-line treatment setting.

According to Hammers, we need to develop strategies on how to better enhance the immune response and better select patients who can benefit from a moderate immunotherapy approach, or an intensified immunotherapy approach to improve efficacy.

Frontline therapy with the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) reduced the risk of death by 32% compared with standard sunitinib (Sutent) for patients with metastatic disease, according to data from the CheckMate-214 study. Median overall survival was not reached with the combination versus 32.9 months with sunitinib. In intermediate- and poor-risk patients with RCC, there was a 37% reduction in the risk of death. Moreover, progression-free survival in the intermediate- and poor-risk group was 11.6 months with the combination compared with 8.4 months with sunitinib. Across the full study, the overall response rates were 39% and 32% with nivolumab/ipilimumab versus sunitinib, respectively.