A study published in Clinical Genitourinary Cancer this month looks at treating patients with favourable risk metastatic renal cell carcinoma (RCC) and elderly patients with a combination of immune checkpoint inhibitors and vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs).
Immune checkpoint inhibitors and VEGFR inhibitors are the most commonly used medications for the treatment of metastatic RCC. Recently, large clinical trials have shown favourable outcomes in patients treated with a combination of immune checkpoint inhibitors plus VEGFR inhibitors compared with VEGFR inhibitors alone. However, the benefit of this combination of treatments in patients with favourable risk disease or among elderly (age > 65 years) patients was not clear.
During this study, results from phase III randomised clinical trials of combinations immunotherapy plus a VEGFR inhibitor were analysed to look at the efficacy of immunotherapy/VEGFR inhibitor combinations compared with sunitinib in favourable risk and elderly patients.
Progression-free survival was significantly prolonged with combination therapy compared with sunitinib in patients more than 65 years and was improved in patients with favourable risk disease (but the difference was not statistically significant).
In conclusion, this analysis provides evidence that favourable risk and elderly patients with metastatic RCC will likely benefit from treatment with a combination of an immune checkpoint inhibitor and VEGFR inhibitor.