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The 2021 Updated European Association of Urology Guidelines on Renal Cell Carcinoma : Immune Checkpoint Inhibitor–based Combination Therapies for Treatment-naive Metastatic Clear-cell Renal Cell Carcinoma Are Standard of Care

Bedke, Jens ; Albiges, Laurence ; Capitanio, Umberto ; Giles, Rachel H. ; Hora, Milan ; Lam, Thomas B. ; Ljungberg, Börje ; Marconi, Lorenzo ; Klatte, Tobias and Volpe, Alessandro , et al. (2021) In European Urology 80(4). p.393-397
Abstract

The recent randomized controlled phase III CLEAR trial results are the last to complement immune checkpoint inhibitor (ICI)-based doublet combination therapies for treatment-naïve metastatic clear-cell renal cell carcinoma. The CLEAR trial demonstrated an improved progression-free survival (PFS), overall survival (OS), and an objective response rate (ORR) benefit for the combination of lenvatinib plus pembrolizumab over sunitinib. The CheckMate-9ER trial update demonstrated an ongoing PFS, OS, and quality-of-life benefit for cabozantinib plus nivolumab over sunitinib as did the update of Keynote-426 for axitinib plus pembrolizumab in the intention-to-treat population, with a PFS benefit seen across all International Metastatic Database... (More)

The recent randomized controlled phase III CLEAR trial results are the last to complement immune checkpoint inhibitor (ICI)-based doublet combination therapies for treatment-naïve metastatic clear-cell renal cell carcinoma. The CLEAR trial demonstrated an improved progression-free survival (PFS), overall survival (OS), and an objective response rate (ORR) benefit for the combination of lenvatinib plus pembrolizumab over sunitinib. The CheckMate-9ER trial update demonstrated an ongoing PFS, OS, and quality-of-life benefit for cabozantinib plus nivolumab over sunitinib as did the update of Keynote-426 for axitinib plus pembrolizumab in the intention-to-treat population, with a PFS benefit seen across all International Metastatic Database Consortium (IMDC) subgroups. In the IMDC intermediate- and poor-risk groups, the CheckMate-214 trial of ipilimumab plus nivolumab confirmed the OS benefit with a PFS plateauing after 30 months. The RCC Guidelines Panel recommends three tyrosine kinase inhibitors + ICI combinations of axitinib plus pembrolizumab, cabozantinib plus nivolumab, and lenvatinib plus pembrolizumab across all IMDC risk groups in advanced first-line RCC, and dual immunotherapy of ipilimumab and nivolumab in IMDC intermediate- and poor-risk groups. Patient summary: New data from combination trials with immune checkpoint inhibitors for advanced kidney cancer confirm a survival benefit for lenvatinib plus pembrolizumab, cabozantinib plus nivolumab (with improved quality-of-life), axitinib plus pembrolizumab, and ipilimumab plus nivolumab. These combination therapies are recommended as first-line treatment for advanced kidney cancer.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cabozantinib, Clear-cell, First-line, Lenvatinib, pembrolzumab, nivolumab, Renal cell carcinoma, Systemic therapy, Treatment-naive
in
European Urology
volume
80
issue
4
pages
5 pages
publisher
Elsevier
external identifiers
  • scopus:85107068841
  • pmid:34074559
ISSN
0302-2838
DOI
10.1016/j.eururo.2021.04.042
language
English
LU publication?
yes
id
a01343e4-9645-481d-8e72-2ed01de64640
date added to LUP
2021-12-28 13:21:40
date last changed
2022-05-24 18:53:56
@misc{a01343e4-9645-481d-8e72-2ed01de64640,
  abstract     = {{<p>The recent randomized controlled phase III CLEAR trial results are the last to complement immune checkpoint inhibitor (ICI)-based doublet combination therapies for treatment-naïve metastatic clear-cell renal cell carcinoma. The CLEAR trial demonstrated an improved progression-free survival (PFS), overall survival (OS), and an objective response rate (ORR) benefit for the combination of lenvatinib plus pembrolizumab over sunitinib. The CheckMate-9ER trial update demonstrated an ongoing PFS, OS, and quality-of-life benefit for cabozantinib plus nivolumab over sunitinib as did the update of Keynote-426 for axitinib plus pembrolizumab in the intention-to-treat population, with a PFS benefit seen across all International Metastatic Database Consortium (IMDC) subgroups. In the IMDC intermediate- and poor-risk groups, the CheckMate-214 trial of ipilimumab plus nivolumab confirmed the OS benefit with a PFS plateauing after 30 months. The RCC Guidelines Panel recommends three tyrosine kinase inhibitors + ICI combinations of axitinib plus pembrolizumab, cabozantinib plus nivolumab, and lenvatinib plus pembrolizumab across all IMDC risk groups in advanced first-line RCC, and dual immunotherapy of ipilimumab and nivolumab in IMDC intermediate- and poor-risk groups. Patient summary: New data from combination trials with immune checkpoint inhibitors for advanced kidney cancer confirm a survival benefit for lenvatinib plus pembrolizumab, cabozantinib plus nivolumab (with improved quality-of-life), axitinib plus pembrolizumab, and ipilimumab plus nivolumab. These combination therapies are recommended as first-line treatment for advanced kidney cancer.</p>}},
  author       = {{Bedke, Jens and Albiges, Laurence and Capitanio, Umberto and Giles, Rachel H. and Hora, Milan and Lam, Thomas B. and Ljungberg, Börje and Marconi, Lorenzo and Klatte, Tobias and Volpe, Alessandro and Abu-Ghanem, Yasmin and Dabestani, Saeed and Pello, Sergio Fernández and Hofmann, Fabian and Kuusk, Teele and Tahbaz, Rana and Powles, Thomas and Bex, Axel}},
  issn         = {{0302-2838}},
  keywords     = {{Cabozantinib; Clear-cell; First-line; Lenvatinib, pembrolzumab, nivolumab; Renal cell carcinoma; Systemic therapy; Treatment-naive}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{393--397}},
  publisher    = {{Elsevier}},
  series       = {{European Urology}},
  title        = {{The 2021 Updated European Association of Urology Guidelines on Renal Cell Carcinoma : Immune Checkpoint Inhibitor–based Combination Therapies for Treatment-naive Metastatic Clear-cell Renal Cell Carcinoma Are Standard of Care}},
  url          = {{http://dx.doi.org/10.1016/j.eururo.2021.04.042}},
  doi          = {{10.1016/j.eururo.2021.04.042}},
  volume       = {{80}},
  year         = {{2021}},
}