In this paper, three clinical trials with immunotherapy combinations for the first-line treatment of clear renal cell carcinoma (RCC) are discussed. Dr  Robert Motzer from Memorial Sloan Kettering Cancer Center in New York compared the findings from the three trials at the Annual Chemotherapy Foundation Symposium (CFS) in New York last week.

All three phase III randomised clinical trials had a sunitinib control arm. The CheckMate 214 trial (1096 patients) looked at nivolumab plus ipilimumab; the KEYNOTE-426 trial (861 patients) assessed pembrolizumab plus the tyrosine kinase inhibitor (TKI) axitinib; and JAVELIN Renal 101 (886 patients) explored avelumab plus axitinib.

Based on the data he presented, Dr Motzer said that for intermediate- and poor-risk patients, “Nivolumab/ipilimumab or pembrolizumab/axitinib are both good choices and the primary choices that I offer my patients. It’s often an individual decision for the risks/benefits of one versus the other with each patient.”

He added, “All things aside, I tip toward nivolumab/ipilimumab in these patients because of the fact that data are more mature and [positive] quality-of-life data are available.”

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