In this interview with OncLive, Dr Ulka Vaishampayan from Wayne State University in Detroit, USA discusses the immunotherapy combinations that have been approved for first line treatment of metastatic renal cell carcinoma (mRCC) over the past year or so, and the need to identify biomarkers that can guide treatment selection for these patients.
The combination of nivolumab and ipilimumab for patients with intermediate- and poor-risk metastatic RCC demonstrated a 32% reduction in risk of death with the combination compared with sunitinib, axitinib and pembrolizumab showed a 47% reduction in the risk of death versus sunitinib, and axitinib and avelumab showed a 31% reduction in the risk of disease progression or death with the combination versus sunitinib.
These approvals have changed the way clinicians treat metastatic RCC patients; however, predictive biomarkers are needed to help with treatment selection for these patients.
“The question is, still, ‘How do we choose between these regimens?’” explained Dr Vaishampayan. “Right now, we have no validated biomarkers to guide our selection. Knowing whether a patient is likely to respond to an immune-based regimen or an anti-VEGF–based regimen could save a lot of toxicity and time for patients. Not everybody responds to immunotherapy, so a patient may be receiving one treatment while they could have benefited from another.”