Did you know how to treat kidney cancer?

According to researchers from the Dana-Farber Cancer Institute, USA, a drug combination could be used for the treatment of patients with advanced kidney cancer.

Patients who received the drug combination of avonable immunotherapy and axitinib, a targeted agent, reported to have a significant advantage in progression-free survival compared to those who received sunitinib (Sutent), clear cell renal cell carcinoma – the most common form of advanced kidney cancer.

Let's talk drug combinations

Toni K. Choueiri, Professor of Medicine at Harvard Medical School, USA, explains: "Patients receiving the drug combination also had a higher response rate – meaning their tumors shrank – than the sunitinib-only group."

"This is certainly better than sunitinib – hopefully this will lead to Food and Drug Administration approval soon."

While progression-free survival has been improved with the drug combination, additional follow-up will be required to increase the overall survival compared to the standard regimen.

The trial is the first pivotal study to combine avascular cell endothelial growth factor receptor (VEGFR).

VEGFR blockers like sunitinib and axitinib are designed to starve tumors by disrupting their blood supply. Immunotherapy drugs such as avelumab – which blocks an immune checkpoint called PD-L1 – work by activating the 'exhausted' immune cells so they can more effectively attack cancer cells.

Details of the study

The clinical trial involved 886 patients with previously untreated, advanced renal cell carcinoma who were randomized to receive the drug or sunitinib alone.

The results presented that the median progression-free survival (PFS) – the period of time before cancer – was 13.8 months in the group and 7.2 months in patients receiving only sunitinib.

These patients were specifically tested for patients whose cancer cells tested positive for the PD-L1 checkpoint that is blocked by avelumab. The PFS for the overall population (PD-L1 positive or negative) was similar – 13.8 months versus 8.4 months.

The proportion of patients whose tumors were 55.2% with avelumab plus axitinib and 25.5% with sunitinib in patients who were positive for PD-L1.

Are patients benefiting from the combination drug treatment?

Nearly all patients in both treatment groups experienced some side effects. In the combination treatment group, 38.2% of patients experienced immune-related adverse events, the most frequent being thyroid disorders, observed in 107 patients.

Choueiri said that for patients with advanced disease, "this is an important option. What we're doing in advanced kidney cancer is pushing the envelope – these treatments may not be curative, but patients are living longer, and the disease is becoming more chronic. "

Nevertheless, Choueiri adds: "Interestingly, the badysis showed that all subgroups – good, intermediate, and poor-risk patient – benefited from the combination treatment."