Dr. McDermott on Novel Immunotherapy Combinations in RCC

David F. McDermott, MD, director of the Biologic Therapy Program at Beth Israel Deaconess Medical Center, discusses novel immunotherapy combinations for patients with metastatic renal cell carcinoma (RCC).

According to McDermott, an exciting area of study is the combination of VEGF blockade and PD-1/PD-L1 blockade. There are 5 or 6 large randomized trials looking at various combinations, explains McDermott. The early data from phase I trials show that there are high response rates and longer progression-free survival (PFS) than expected with either strategy alone.

As we get into 2018 and 2019, we will start seeing the results of these randomized trials, says McDermott. If they are positive, there could be the fusion of the 2 effective strategies for kidney cancer in the first-line setting. Perhaps there will be 5 or 6 versions of combinations, which will be the next big thing for metastatic patients.

Several such combinations are under investigation, with the most data available so far being from a phase Ib study of axitinib (Inlyta) plus pembrolizumab (Keytruda). The results of this study were for 52 patients with advanced RCC who received frontline treatment with axitinib plus pembrolizumab. The overall response rate was 67.3% (35 patients), including 2 complete responses and 33 partial responses. The researchers also reported that the combination was well tolerated.