Transforming Treatmentby Travis Marshall
Targeted therapies and immunotherapies are helping people with advanced kidney cancer live longer. “These two broad classes of drugs are transforming the outlook for advanced kidney cancers,” says Dr. Akhtar. “Previously, the prognosis for these patients was very poor, but now with new treatments, we’re seeing better responses.”
Targeted therapies disrupt specific functions within cancer cells, such as blood vessel formation or cell division. Immunotherapies empower your natural immune defenses to better fight cancer.
Exciting recent research has found benefit in combining these two treatment types. One landmark change came in April 2018, when the Food & Drug Administration (FDA) approved a combination of the immunotherapies nivolumab (Opdivo) and ipilimumab (Yervoy) as firstline treatment for some types of advanced renal cell carcinoma (RCC), or kidney cancer.
In March 2019, a phase 3 study published in the New England Journal of Medicine compared a targeted therapy, sunitinib (Sutent), with a combination of the targeted therapy axitinib (Inlyta) and the immunotherapy avelumab (Bavencio). For the sunitinib-only group, progression-free survival time averaged 7.2 months, compared with 13.8 months for the combination group. In addition, 55.2 percent of those in the combination group experienced tumor shrinkage, compared with 25.5 percent of the sunitinib-only group.
In April 2019, the FDA approved the combination of pembrolizumab (Keytruda) and axitinib (Inlyta) as a firstline treatment for advanced renal cell carcinoma. The approval was based on results of KEYNOTE 426, a clinical trial involving 861 patients who had not had any systemic therapy for advanced kidney cancer. Patients were given either sunitinib daily for four weeks, then off treatment for two weeks, or a combo of IV pembrolizumab every three weeks plus axitinib twice daily.
Results showed significant improvement in overall survival for those on pembrolizumab plus axitinib, and progression-free survival of 15.1 months for pembrolizumab plus axitinib versus 11.1 months for sunitinib only.