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According to a new study, using an existing drug for advanced kidney cancer at an early stage of the disease could reduce the risk of cancer recurrence by a third.
The results of the phase III trial are presented today at the congress of the European Association of Urology (EAU21). There is a high risk of kidney cancer returning after surgery to remove the tumors, but there is currently no treatment to help prevent this.
The KEYNOTE study involved just under 1,000 kidney cancer patients who had undergone surgery. Half of them received the immunotherapy drug pembrolizumab, or pembro, and the other half received a placebo.
Pembro is used to treat a number of cancers, including advanced kidney cancer where the disease has spread to other organs. The international trial in 20 countries was the first time the drug had been used with patients at an early stage of the disease.
The team found that over two years, patients on pembro were one-third less likely to have their disease recurring than those on placebo. Patient follow-up continues to determine the impact of treatment on survival rates over a five-year period.
The study also showed that the side effects of the drug were similar to those normally expected with cancer treatment.
Study co-investigator Professor Thomas Powles of the Barts Cancer Institute at Queen Mary University in London said: “These early data from the trial are very promising, with a marked reduction in recurrence of the disease. disease in patients on pembro. There are signs that the drug may improve survival rates, but we cannot be sure for a few years. We hope that this trial, when completed, will provide a strong case for this drug to be approved for use by the drug regulator. “
Promising combination immunotherapy for advanced bladder cancer
Professor Powles is presenting further results from another trial at EAU21 today, which also involves a new use of an existing cancer immunotherapy drug. The DANUBE study looked at durvalumab in patients with advanced bladder cancer, where the disease had already spread to other parts of the body. Durvalumab is widely used as a treatment for lung cancer, especially in the United States.
Over 1,000 patients were enrolled for the trial, one-third receiving durvalumab, one-third receiving durvalumab in combination with a new immunotherapy drug, tremelimumab, and one-third receiving standard chemotherapy.
They found that overall, immunotherapy drugs did not increase survival more than standard chemotherapy.
However, in the exploratory analysis, in a subset of patients (those who had an elevated level of a specific biomarker (PD-L1) and who were not eligible for the chemotherapeutic drug cisplatin), the activity of the durvalumab was increased by the addition of tremilimumab.
Professor Powles said: “Although we did not compare durvalumab to other immune therapies authorized in this clinical situation, we could see that the new combination of immunotherapies showed additional promise that deserved more detailed examination.”
Two large randomized controlled trials are currently underway testing durvalumab and tremelimumab against existing immunotherapy treatments, both in advanced and early bladder cancer, in patients with elevated levels. LD-P1 biomarker that cannot receive cisplatin. The results of the first trial are expected to be released later this year, while the other is still being recruited.
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