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Kidney cancer

Perioperative immunotherapy for renal cell carcinoma: looking beyond the data

The first phase III trial to test perioperative immune-checkpoint inhibitor therapy for high-risk renal cell carcinoma yielded highly promising results, leading to regulatory approvals of adjuvant pembrolizumab. However, subsequent phase III trials, including the IMmotion010 trial of adjuvant atezolizumab, did not demonstrate similar benefits. Although molecular biomarkers are urgently needed to better delineate responder subgroups, the unique design of each trial might partially explain some of the patterns identified.

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Fig. 1: Comparison of key eligibility criteria among phase III trials evaluating immune-checkpoint inhibitors in the perioperative setting in patients with renal cell carcinoma.


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The work of T.K.C. is supported in part by Dana-Farber/Harvard Cancer Center Kidney SPORE (2P50CA101942-16) and Program (5P30CA006516-56) grants, the Kohlberg Chair at Harvard Medical School and the Trust Family, Michael Brigham, Pan Mass Challenge and Loker Pinard Funds for Kidney Cancer Research at the Dana-Farber Cancer Institute.

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Correspondence to Toni K. Choueiri.

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Competing interests

C.L. has received grants from Genentech/imCORE. T.K.C. reports institutional and personal, paid and unpaid support for research, advisory boards, consultancy and honoraria from AstraZeneca, Aravive, Aveo, Bayer, Bristol Myers Squibb, Calithera, Circle Pharma, Eisai, EMD Serono, Exelixis, GlaxoSmithKline, IQVA, Infinity, Ipsen, Jansen, Kanaph, Lilly, Merck, Nikang, Nuscan, Novartis, Pfizer, Roche, Sanofi/Aventis, Surface Oncology, Takeda, Tempest, and Up-To-Date, and for CME events from Peerview, OncLive, MJH and others, outside of the submitted work; institutional patents filed on molecular alterations and immunotherapy response/toxicity, and ctDNA; equity in Osel, Pionyr, Precede Bio, and Tempest; committee membership for ACCRU, ASCO, ESMO, KidneyCan and the NCCN GU Steering Committee; medical writing and editorial assistance support that might have been funded in part by communications companies; mentorship of several non-US citizens on research projects with potential funding, in part, from non-US sources/foreign components. The institution of C.L. and T.K.C. (Dana-Farber Cancer Institute) might have received additional independent funding from pharmaceutical companies and/or royalties potentially involved in research around the subject matter.

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Labaki, C., Choueiri, T.K. Perioperative immunotherapy for renal cell carcinoma: looking beyond the data. Nat Rev Clin Oncol (2022).

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