Bladder Cancer Academy 2017: Immunotherapy of Renal Cell Carcinoma

Schaumburg, IL ( Dr. Hammers gave a presentation on immunotherapy in renal cell carcinoma (RCC). RCC does not have a very high nor low somatic mutation frequency, being placed right in the middle of all cancers. High dose IL-2 was the first immunotherapy used in RCC in the past, achieving a complete response (CR) in about 5% of patients.

Nowadays, CheckMate 025 was a trial comparing Nivolumab to Everolimus, showing no significant differences in progression free survival (PFS). However, it did show a higher objective response rate (ORR) for all MSKCC risk groups for Nivolumab compared to Everolimus (favourable 24% vs. 8%, Intermediate 25% vs. 5% and poor 27% vs. 3%).

The next step is combining therapies together, for instance, the VEGF inhibitors together with immunotherapy. There are selective Tyrosine kinase inhibitors (TKIS) together combined with immune check point inhibitors (ICPI). These include axitinib and Tivozantinib. There are also multi-targeted TKI, which are combined with ICPI, including Cabozantinib and Lenvatinib. Another potentially useful combination is the ICPI together with CTLA. This combination has been examined in the Checkmate 16 trial, comparing Nivolumab +Ipilimumab in different dosages. This trial has shown an ORR of 40% in all arms.

Dr. Hammers concluded that the future holds many combination possibilities for these different medications in RCC, potentially resulting in a non-immune synergy.

Presented By: Hans Hammers, MD, PhD, UT Southwestern Medical Center

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre
Twitter: @GoldbergHanan

at the 2017 Bladder Cancer Academy - June 9 - 10 - Schaumburg, Illinois, USA