Available Therapies Give Physicians Multiple Options in First Line RCC

Vivek Subbiah, MD, of the Department of Investigational Cancer Therapeutics, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the frontline therapeutic options for patients with renal cell carcinoma (RCC).

In the first-line setting for this disease, the agents available in the United States include sunitinib (Suntent), pazopanib (Vortriant), tivozanib (Fotivda), and bevacizumab (Avastin) plus interferon. Tivozanib is also approved in Europe in the first line. Subbiah says that more and more frequently, immunotherapy data has been investigated, such as the checkpoint combination therapy of ipilimumab (Yervoy) and nivolumab (Opdivo).

Over the last 5 years, there has been amazing activity in the immunotherapy space, according to Subbiah. At this point, based on approvals and follow-up data, the checkpoint inhibitor combination of the CTLA4 antibody and PD-1 inhibitor has demonstrated the best data so far in the first line setting for patients with RCC.

Although these regimens are available, not all patients are being cured with these treatments. Most patients have an improvement in progression-free survival, but there is still an unmet need for patients in the second-, third-, and fourth-line setting.

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