Dr. Pal Discusses the Role of PD-L1 in Metastatic RCC

Sumanta Kumar Pal, MD, associate clinical professor, Department of Medical Oncology and Therapeutics Research, co-director, Kidney Cancer Program, City of Hope, discusses the role of PD-L1 in metastatic renal cell carcinoma (RCC).

One of the biggest unanswered questions in the frontline setting of metastatic RCC is the role of PD-L1. Pal says that there is more to the PD-L1 story, particularly considering the findings of the CheckMate-214 trial. There was a clear difference in clinical outcomes for patients who were PD-L1—positive versus PD-L1–negative, Pal explains. Whether that is clinically applicable is not established.

Findings from the phase III CheckMate-214 trial showed that the frontline treatment with the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) reduced the risk of death by 32% compared with sunitinib (Sutent) for patients with metastatic RCC. The risk reduction was 37% in patients with intermediate- and poor-risk RCC, who constituted about 75% of the intent-to-treat (ITT) population. About one-fourth in the ITT population had PD-L1 expression ≥1%.

Pal believes that PD-L1, along with the other established genomic markers in RCC, will have a role in the treatment of patients in the frontline metastatic setting.