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In this video interview from Practice Update, Dr Eric Jonasch from MD Anderson Cancer Center in the USA talks about some interesting data on brain metastases in patients who have received a combination therapy.
Renal cell carcinoma (RCC) patients will develop brain metastases in about 10% to 20% of the time, and the treatment for brain metastases is an unmet need. Currently, patients with brain metastases are treated with surgery, stereotactic radio-surgery, and systemic treatments. In addition, patients with brain metastases typically have not been included in large phase 3 clinical trials because of concerns about outcomes.
In a recent phase 3 study with nearly 900 patients, about 5% of patients had brain metastases when enrolled in the study. Patients were randomised and treated with either with avelumab plus axitinib, or with sunitinib alone. Progression-free survival was almost 5 months for patients with brain metastases who received avelumab plus axitinib versus a bit less than 3 months for patients who were treated with sunitinib, but the difference between progression-free survival for each treatment was not statistically significant. New brain metastases developed in 8 patients on the avelumab plus axitinib arm and 10 patients in the sunitinib arm, and again this was not statistically significant.
People with kidney cancer that has spread to the brain still face a very tough path, but this study with a small group of patients gives some hope that new treatments might help in this very difficult situation.