A paper published in The Lancet Oncology this month provides further follow-up data from the KEYNOTE-426 study, which shows superior efficacy of pembrolizumab plus axitinib over sunitinib in patients with untreated advanced renal cell carcinoma (RCC).

Eight hundred and sixty one (861) patients were randomly assigned to receive pembrolizumab plus axitinib (432) or sunitinib (429). In the current analysis, the follow-up period was around 30·6 months and pembrolizumab plus axitinib continued to show benefit over sunitinib in terms of overall survival (median not reached with pembrolizumab and axitinib vs 35·7 months with sunitinib) and how long it took for the cancer to start to grow again (progression-free survival; median 15·4 months vs 11·1 months for sunitinib).

The most frequent treatment-related severe or life-threatening side effects were hypertension (22% in the pembrolizumab plus axitinib group vs 20% in the sunitinib group), an increase in a protein called alanine aminotransferase which indicates problems with the liver (13% vs 3%), and diarrhoea (11% vs 5%). There have not been any more treatment-related deaths since the first analysis.

In summary, this longer follow-up from KEYNOTE-426 shows that pembrolizumab plus axitinib continues to have better survival outcomes than sunitinib.