A meta-analysis of four major clinical trials of immunotherapy combinations for the first-line treatment of metastatic renal cell carcinoma (RCC) was published in the journal Clinical Genitourinary Cancer earlier this month.
The analysis compared progression-free survival, overall survival and objective response rate from four major clinical trials: CheckMate 214 (nivolumab/ipilimumab vs sunitinib), Keynote-426 (pembrolizumab/axitinib vs sunitinib), IMmotion151 (atezolizumab/bevacizumab vs sunitinib), and JAVELIN Renal 101 (avelumab/axitinib vs sunitinib).
There was no significant difference in overall survival with pembrolizumab/axitinib and nivolumab/ipilimumab on indirect comparison of the data from CheckMate 214 and Keynote-426. However, pembrolizumab/axitinib had the edge over nivolumab/ipilimumab in terms of overall survival, although the difference was not statistically significant. There was no difference between the four combination treatments in terms of progression-free survival. Overall response rates were similar with pembrolizumab/axitinib and avelumab/axitinib, and these combination treatments showed higher overall response rates than nivolumab/ipilimumab or atezolizumab/bevacizumab.
In summary, the clinical outcomes of these four combination immunotherapy treatments for metastatic RCC appear to be similar. These findings may help in the decision-making process for first-line treatments. Immunotherapy and vascular endothelial growth factor tyrosine kinase inhibitor (VEGF-TKI) combinations (pembrolizumab/axitinib and avelumab/axitinib) appear to be the most effective in terms of progression-free survival and tumour responses.