Dr. McGregor on Combos With Nivolumab, Cabozantinib, and Sunitinib in RCC

Bradley McGregor, MD, clinical director, Lank Center for Genitourinary Oncology, senior physician, Dana-Farber Cancer Institute, and instructor of medicine, Harvard Medical School, discusses combination therapies with nivolumab (Opdivo), cabozantinib (Cabometyx), and sunitinib (Sutent) in renal cell carcinoma (RCC).

There has been a revolution within therapy of RCC in the past couple of years, says McGregor. The initial data from the CheckMate-9ER study showed that the combination of nivolumab and cabozantinib improved overall survival when compared with sunitinib in the frontline setting of patients with intermediate- and poor-risk disease. More recently, there have also been combinations of sunitinib with either pembrolizumab (Keytruda) or durvalumab (Imfinzi), which have shown to improve progression-free survival, and in the case of sunitinib and pembrolizumab, there was an overall survival benefit, as well.

Cabozantinib is a multikinase, small molecule receptor TKI, McGregor added. Data from the CABOSUN study showed efficacy with cabozantinib in the frontline and second-line settings; the drug was compared with sunitinib. I am continuously looking to see if there is an improvement in response rates and the outcomes of patients with RCC in the frontline setting with combination therapy, concludes McGregor.