Impact of TKI Combinations in Front-Line Treatment of RCC

Updated results presented at the American Society of Clinical Oncology (ASCO) annual meeting involved frontline therapy in metastatic renal cell carcinoma (RCC), including the 5-year analysis of axitinib (Inlyta) plus pembrolizumab (Keytruda) in the phase III KEYNOTE-426 trial, and the prespecified overall survival (OS) analysis at 4 years of follow-up for lenvatinib (Lenvima) plus pembrolizumab versus sunitinib in the phase III CLEAR trial.

In this exclusive MedPage Today video, Kathryn Beckermann, MD, PhD, of Vanderbilt University Medical Center in Nashville, discusses the enthusiasm around the data, and what comes next.

Following is a transcript of her remarks:

I enjoyed the discussion — also updated this year at ASCO were two big frontline trials. So, the CLEAR trial updated its overall survival data, and so did KEYNOTE-426, and these are both IO/TKIs [immuno-oncology/tyrosine kinase inhibitors] that we’ve been using in the frontline setting.

Again, we know that these agents have great objective response rate, great PFS [progression-free survival] rate, but the question now is that as we look at the Kaplan-Meier curves at the end of the follow-up, it appears that the curves seem to be coming together a bit more.

I think the discussion that I want to highlight was that there was a lot of enthusiasm about how do we choose front-line treatment? And I think that’s not an answered question — that we have to learn better either how to pick the right one based on the patient’s biology; we need better biomarkers. Or, do we need to intensify maybe other triplets that will be studied in the future, upcoming year or so, that tell us we can capture more patient population by adding more agents as long as we can minimize the toxicity.

So, I think that was the other data that was really interesting at ASCO this year.