Dr. Powles on Monitoring Immunotherapy Effects in Patients with RCC

Thomas Powles, MBBS, MRCP, MD, director, Barts Cancer Institute, discusses the importance of accurately assessing the toxicity profiles of immunotherapies for renal cell carcinoma (RCC).

Powles believes immunotherapies are going to change practice; therefore, physicians need to learn how to optimally administer them. Overall, the toxicity profile for immunotherapy is acceptable, but it is important to pay close attention to adverse events, such as diarrhea and transaminitis, which were historically treated with VEGF-targeted therapy or stopping treatment. Physicians can intervene with steroids where appropriate. Powles recommends physicians go through a period of education and training to become well-informed on immune-related toxicities, which seems prominent when given in combination with VEGF targeted therapy.

Powles has treated several patients with axitinib (Inlyta) and pembrolizumab (Keytruda) and the majority do very well with a combination. However, when the combination was first being tested, Powles needed to make sure the dosing was optimized, patients were educated properly, and if problems occurred, patients knew who to contact. Closely monitoring the effects of immunotherapy in RCC is going to be really important for the future, according to Powles.