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Results from the phase 1/2 RAPPORT trial show that stereotactic radiotherapy followed by 8 cycles of pembrolizumab treatment is effective in patients with small numbers of renal cell carcinoma (RCC) metastases (oligometastatic kidney cancer).
In this study, 30 patients who had been previously treated with 2 or less prior cancer medicines had stereotactic radiotherapy to metastases in their adrenal glands, bones, lung, lymph nodes, and soft tissue. Most patients (27) had had a nephrectomy, while 9 of these patients had also had metastases removed by surgery. Three patient had had no prior surgery.
Treatment was generally well tolerated. After an average follow-up time of 28 months, 40% of patients had a complete response, 23% had a partial response, and 23% had stable disease. The majority of patients (92%) were free from local progression after two years.
The results of this early trial suggest that the combination of stereotactic radiotherapy and a short course of immunotherapy is effective for patients with RCC and small numbers of metastases, but needs further investigation.