GU Cancers 2018 | The agents at the forefront of kidney cancer treatment

Michael Atkins

Speaking from the 2018 Genitourinary Cancers Symposium, held in San Francisco, CA, Michael Atkins, MD, of Georgetown University, Washington, DC, outlines the changing landscape of kidney cancer, explaining the therapies at the forefront of the field right now. Dr Atkins highlights immuno-oncology combinations, mentioning a number of checkpoint inhibitors and VEGF inhibitors, including ipilimumab, nivolumab, atezolizumab, bevacizumab, cabozantinib, lenvatinib, everolimus, axitinib, avelumab, and sunitinib.

Transcript (edited for clarity):

The current treatment landscape is changing regularly in kidney cancer. I think, as of the data that we’ve seen in 2018, checkpoint inhibitor immune therapy is going to be the most common approach used in the frontline, with probably the nivolumab/ipilimumab combination being used for intermediate and poor risk patients and possibly some selected favorable-risk patients and atezolizumab bevacizumab having a role in patients where there’s a concern about giving them ipilimumab and subsequent lines of therapy need to be sorted out which could be cabozantinib could be when lenvatinib everolimus, creating not much of a role for axitinib as a mono therapy. However, the data from axitinib combined with pembrolizumab or axitinib combined with avelumab and the phase 3 trials comparing that with sunitinib will likely lead to those regimens being approved for the frontline setting and then patients and physicians are going to have to decide whether they go with the IO combination of nivolumab plus ipilimumab the IO anti veg F antibody of atezolizumab plus bevacizumab or the IO TKI data and I’m not sure how we’re going to sort this out. I have my own views about what I would do but we’re going to need more data to be able to address that question.

Ultimately there are going to be patients identified based on biomarkers who should get IO therapy as their first line treatment and there are going to be patients identified who should get some veg F inhibitor in their frontline treatment and I think if you’re going to give a veg F inhibitor you’re more likely going to give that in combination with an anti PD1.

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