Advanced/metastatic kidney cancer is often treated with a combination of medicines; either two infusions of immunotherapy (nivolumab and ipilimumab) or immunotherapy (avelumab, pembrolizumab or nivolumab) plus a VEGFR TKI tablet (axitinib, lenvatinib, or cabozantinib).

The phase 3 RENOTORCH study looks at a new immunotherapy infusion (an anti-PD-1 antibody called toripalimab) plus axitinib tablets and compares this combination with sunitinib tablets for the treatment of advanced/metastatic kidney cancer. The findings from this study were presented wt the European Society for Medical Oncology (ESMO) Congress in Madrid on 20-24 October 2023.

There were 421 patients in the study with untreated advanced/metastatic clear cell kidney cancer who had intermediate or poor risk disease. Patients were randomly put into two groups to be treated with either a toripalimab infusion once every 3 weeks plus axitinib tablets or sunitinib tablets alone.

Patients were followed for an average of just over one year. Toripalimab plus axitinib increased the time to when the treatment stopped working and the cancer started growing again (progression-free survival) compared to sunitinib (18 months compared to 9.8 months, respectively). More than half of the patients responded to the combination treatment and their cancer got smaller compared to less than a third for sunitinib. The average overall survival time was not reached for the patients on the combination and was just over 2 years for sunitinib.

Around two thirds of patients reported serious or life-threatening side effects for each treatment, and the number of deaths were similar for each treatment. More patients stopped treatment because of side effects to the combination treatment (14.4% vs 8.1%).

Treatment with the combination of a new immunotherapy called toripalimab plus axitinib resulted in longer progression-free survival and a better response to treatment compared with sunitinib in patients with untreated advanced/metastatic kidney cancer. The results from this study support the use of toripalimab with axitinib as a first treatment for advanced kidney cancer. However, overall survival information is not available yet.

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