Renal Cell Carcinoma | Oncology Today with Dr Neil Love: Renal Cell Carcinoma Edition

A virtual roundtable discussion with noted investigators Dr Toni K Choueiri and Prof Thomas Powles for a review of recent innovations in the treatment of renal cell carcinoma. Risk stratification and selection of first-line therapy for metastatic renal cell carcinoma (mRCC) (00:00) Role of cytoreductive nephrectomy in RCC (1:50) Overall survival and complete response (CR) improvements with the FDA-approved nivolumab/ipilimumab combination versus sunitinib for intermediate- or poor-risk previously untreated advanced RCC on the Phase III CheckMate 214 trial (4:18) Activity of nivolumab alone or in combination with ipilimumab for patients with mRCC and brain metastases (9:25) Tolerability of nivolumab/ipilimumab; risk of immune-related adverse events (AEs) (11:21) Recent FDA approvals of avelumab with axitinib (JAVELIN Renal 101) and pembrolizumab with axitinib (KEYNOTE-426) as first-line treatment for advanced RCC (13:24) Comparison of cellular distribution, activity and tolerability of anti-PD-1 versus PD-L1 antibodies (14:14) Similarities and differences in clinical outcomes among the JAVELIN Renal 101 (avelumab/axitinib) and KEYNOTE-426 (pembrolizumab/axitinib) trials (19:01) Indirect comparison of the efficacy and tolerability of nivolumab/ipilimumab versus avelumab/axitinib and pembrolizumab/axitinib (26:35) Importance of educating patients and community practitioners on the distinction between immune checkpoint inhibitor- and chemotherapy-related side effects (30:55) Choosing among newly approved first-line therapeutic options for mRCC (ie, avelumab/axitinib, pembrolizumab/axitinib, nivolumab/ipilimumab); factors influencing whether to use a VEGF tyrosine kinase inhibitor (32:45) Perspective on the results of the Phase III IMmotion151 trial: Atezolizumab with bevacizumab versus sunitinib in patients with previously untreated mRCC (37:16) Ongoing investigation of anti-PD-1/PD-L1 antibody-based therapy in the (neo)adjuvant settings (41:17) Toward increasing cure rates for patients with RCC (46:09) Approach for patients with no evidence of disease after nephrectomy (50:36) Predictors of benefit with immune checkpoint inhibitors and anti-angiogenic agents (53:16) Case (Dr Choueiri): A man in his mid-60s with clear cell mRCC who receives nivolumab/ipilimumab and for whom nivolumab is held briefly because of a number of rare immune-related AEs ultimately attains a durable near CR (57:50) Clinical experience with and management of rare immune-related AEs in patients receiving checkpoint inhibitors (1:01:11) Case (Prof Powles): A woman in her early 30s with newly diagnosed intermediate-risk mRCC receives nivolumab/ipilimumab (1:09:02) Case (Prof Powles): A man in his late 60s with intermediate-risk, clear cell mRCC experiences low-grade immune checkpoint inhibitor-associated side effects with nivolumab/ipilimumab (1:15:06) Case (Dr Choueiri): A man in his mid-50s with clear cell mRCC receives avelumab/axitinib on a clinical trial (1:18:11) Choosing between pembrolizumab/axitinib and avelumab/axitinib (1:23:18) CME information and select publications