What's Next for Frontline Metastatic RCC Therapy

EP: 1.Reviewing the Choice of First-Line Combinations for Clear Cell RCC and Other Histologies

EP: 2.POLL: What Frontline Treatment Would You Choose for Favorable- and Intermediate-Risk RCC?

EP: 3.Choosing Frontline RCC Therapy After Detecting Metastases in Patient Under Observation

EP: 4.Comparing Physician Experience With Trial Data for Frontline RCC Regimens

EP: 5.Reviewing Updated Survival and Subgroup Data of CheckMate9ER for RCC

EP: 6.Physicians Discuss Potential of Frontline Triplet Regimens for RCC

EP: 7.Opinions on the Optimal Role of Ipilimumab/Nivolumab in RCC

EP: 8.Selecting IO/TKI Therapy for mRCC Based on Patient Profile

EP: 9.Real-World Factors Influence Choice of IO/TKI Regimen for mRCC

EP: 10.Risk Group Data Raises Questions on Choice of Frontline Therapy in RCC

EP: 11.Physicians Discuss Counseling on Immunotherapy Discontinuation in RCC

EP: 12.Updated Data Supports Use of Nivolumab + Cabozantinib in Advanced ccRCC

EP: 13.Nivolumab plus Cabozantinib Continues to Show Benefit in Advanced RCC

EP: 14.Risk Stratification Influences Approach in Frontline Advanced RCC Care

EP: 15.Treatment Selection and Dosing Strategies Based on Trial Data in RCC

EP: 16.Updated Data Shows Durable Efficacy of Cabozantinib/Nivolumab in mRCC

EP: 17.Management of Serious Toxicities with Cabozantinib/Nivolumab in mRCC

EP: 18.Risk Stratification Influences Choice of Frontline IO/TKI Regimen in mRCC

EP: 19.Evolving Evidence Guides Treatment Selection for Favorable-Risk mRCC

EP: 20.Deciding Factors for Front-Line Therapy in Metastatic RCC

EP: 21.Comparing Choices for IO/TKI Combinations in Advanced RCC

EP: 22.Comparing Long-Term Data for IO/IO and IO/TKI in Favorable-Risk mRCC

EP: 23.Frontline Cabo/Nivo in RCC Supported by Risk Status, Metastasis Analyses

EP: 24.GU Oncology Peers Explore Early Therapy Approaches in Low-Volume mRCC

EP: 25.Long-Term Data Prompt Shifting Approaches to Frontline RCC Therapy

EP: 26.Participants Discuss Differences in Treatment in First-Line mRCC

EP: 27.Considering How Favorable Risk Affects Treatment in ccRCC

EP: 28.Primary Progressive Disease Rate Supports IO/TKI Use in Frontline mRCC

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EP: 29.What's Next for Frontline Metastatic RCC Therapy

Alan Tan, MD, assistant professor of Medicine in the division of hematology and oncology at Vanderbilt University Medical Center, discusses upcoming trials that could change the landscape of frontline and adjuvant renal cell carcinoma (RCC) therapy.

Tan says that with the current immunotherapy and tyrosine kinase inhibitor therapy combinations, survival has improved greatly over the past 5 to 10 years, but a plateau has been reached in the frontline metastatic RCC setting in terms of new therapies in the works.

Some newer types of therapy are being investigated in the frontline, such as hypoxia-inducible factor-2α (HIF-2α) inhibitors like belzutifan (Welireg) which is being investigated in combination with pembrolizumab plus lenvatinib in frontline RCC, in the randomized phase 3 LITESPARK-012 trial (NCT04736706), as is the cytotoxic T-lymphocyte–associated protein 4 inhibitor quavonlimab.

Tan also noted that cellular therapies have potential in RCC. At the 2024 International Kidney Cancer Symposium (IKCS), data were presented on chimeric antigen receptor (CAR) T-cell therapies in patients with heavily pretreated RCC, and he suggested these therapies could eventually move to the front line, since patients are willing to try therapies earlier when there is potential for a cure, as with cancer vaccines in the adjuvant setting.

TRANSCRIPTION

0:10 | We've hit a little bit of a plateau in frontline RCC. We've done so well in the last 5 to 10 years. Yes, we are improving survival, but there's some newer kids on the block; HIF-2α is starting to come into play more and more. I'd love to eventually see how that is moved up closer to adjuvant and frontline metastatic RCC. Of course, we have the LITESPARK-012 trial that we still don’t know results for. I think that is something that could change things quite a bit in the frontline setting in the future. But also, cell therapy is coming. We saw some exciting data at IKCS of CAR T in RCC. If it's efficacious in third, fourth, fifth line, I think this is something that patients would want even in first line or vaccine trials in adjuvant, because they're really willing to risk more if there's a chance for a cure.