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KIDNEY CANCER IN 2018

Combination therapy for advanced and metastatic kidney cancer

The treatment of metastatic kidney cancer is rapidly evolving with the shift from immune checkpoint inhibitor monotherapy to combination therapy. In 2018, the combination of nivolumab–ipilimumab received regulatory approval and multiple positive clinical trials were reported with combinations of PD-1 or PD-L1 inhibitors in conjunction with antiangiogenic drugs.

Key advances

  • The randomized phase III CheckMate 214 trial demonstrated that combination therapy with nivolumab–ipilimumab improved objective response rate (ORR) and overall survival (OS) compared with sunitinib3.

  • On the basis of CheckMate 214 (ref.3), the nivolumab–ipilimumab combination received regulatory approval for previously untreated patients with intermediate-risk or poor-risk advanced or metastatic clear cell renal cell carcinoma (ccRCC).

  • The randomized phase II IMmotion150 trial demonstrated promising progression-free survival (PFS) and ORR with the combination of atezolizumab and bevacizumab compared with sunitinib in programmed cell death 1 ligand 1 (PD-L1)+ patients4.

  • The single-arm phase Ib JAVELIN Renal 100 study demonstrated promising objective responses in previously untreated patients with ccRCC treated with avelumab plus axitinib6.

  • Pembrolizumab and axitinib demonstrated promising objective responses and PFS in a single-arm phase Ib trial in previously untreated patients with ccRCC8.

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References

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Correspondence to Chung-Han Lee.

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Competing interests

C.-H.L. has received consulting fees from Eisai and Exelixis, research money and/or grants from Bristol Myers Squibb, Calithera, Eisai, Exelixis and Pfizer. R.J.M. has received consulting fees from Pfizer, Genentech/Roche, Merck, Incyte, Eisai, Exelixis and Novartis, and research money and/or grants from Bristol Myers Squibb, Pfizer, Genentech/Roche and Eisai.

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Lee, CH., Motzer, R.J. Combination therapy for advanced and metastatic kidney cancer. Nat Rev Urol 16, 77–78 (2019). https://doi.org/10.1038/s41585-018-0133-7

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