ESMO 2018 | Combining VEGF TKIs with immunotherapy for RCC

Today there are a range of VEGF tyrosine kinase inhibitors (TKIs) available for use in metastatic renal cell carcinoma. David Quinn, MBBS, PhD, FRACP, from the USC Norris Comprehensive Cancer Center, Los Angeles, CA, provides a review of the available agents and describes how they can be used in combination with immunotherapy agents. The first VEGF TKIs approved were sunitinib and sorafenib, followed later by poziotinib and axitinib. Most recently, cabozantinib has been introduced which not only targets the VEGF pathway but also MET and AXL pathways which are involved in resistance mechanisms and in specific metastasis. Prof. Quinn explains how the introduction of immunotherapies has impacted how VEGF TKIs are selected for use, for example during the European Society for Medical Oncology (ESMO) 2018 Congress, in Munich, Germany, it was presented that pembrolizumab in combination with axitinib was superior to pembrolizumab with sunitinib for progression-free survival and overall survival in renal cell carcinoma.