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Over the past 2 years, the use of combination therapies for the first-line treatment of metastatic renal cell carcinoma (RCC) has become the standard of care for these patients. The first combination was nivolumab plus ipilimumab, which demonstrated a survival benefit over sunitinib in patients with intermediate and poor risk metastatic RCC (CheckMate-214). Shortly after, two immunotherapy-targeted therapy combinations were approved, demonstrating superiority of avelumab and axitinib and pembrolizumab and axitinib, compared to sunitinib in metastatic RCC.
At this year’s European Society of Medical Oncology (ESMO) Virtual Congress 2020, Dr Laurence Albiges from Institut Gustave Roussy in Paris, France presented long-term data of the CheckMate-214 trial comparing nivolumab and ipilimumab to sunitinib, with a focus on the subgroup of patients without a prior nephrectomy.
The combination of nivolumab and ipilimumab continued to impart survival benefits to poor and intermediate risk patients, while there was no appreciable difference among those with favourable risk disease. The results were similar for objective response rates. However, no complete responses were seen.
In patients who have not had nephrectomy and who retain a kidney tumour, median overall survival was longer in patients who were treated with nivolumab/ipilimumab (26.1 months) as compared to sunitinib (14.3 months).