Kidney Cancer

The phase 3 RENOTORCH study is comparing the combination of the PD1-inhibitor toripalimab and axitinib with single-agent sunitinib in patients with renal cell carcinoma.

Results from the phase 1 TRAVERSE trial showed signals of anti-tumor activity with the CAR T-cell therapy ALLO-316 in patients with advanced or metastatic clear cell renal cell carcinoma.

The AACU joined thirteen other organizations in asking the House and Senate appropriations committees to allocate $60 million in FY24 for the KCRP at the Congressionally Directed Medical Research Programs.

In combination, the number of immune cells in and around kidney tumors, the amount of dead cancer tissue, and the mutations of PBRM1 can serve as biomarkers of response to immunotherapy in patients with kidney cancer.

The phase 2 LITESPARK-003 study explored belzutifan plus cabozantinib in patients with locally advanced or metastatic clear cell renal cell carcinoma.

At 5-year follow-up, overall survival among patients with kidney cancer who had quit smoking was 85% compared with 61% for those that continued to smoke.

“These disparities are concerning as the generalizability of clinical trial results relies on the assumption that the population of patients included in a clinical trial represents the overall population of patients with the disease," says Brian M. Shinder, MD.

The median overall survival in renal cell carcinoma patients was similar, regardless of whether or not patients received a break from treatment.

“Now in 2023, it’s really a question of how to apply these agents and which combinations to use in the first line,” said Vincent (Wenxin) Xu, MD.

“As a whole, the benefits of the lenvatinib plus pembrolizumab combination proved to be durable, statistically significant, and clinically meaningful,” said senior author Camillo Porta, MD.

Published results from the phase 3 CONCEPT study showed improved outcomes with the combination compared with either agent alone.

The phase 2 Cyto-KIK study is exploring cytoreductive surgery plus immunotherapy with nivolumab and targeted kinase inhibition with cabozantinib in metastatic kidney cancer.

“As other factors such as access to care, socioeconomic conditions, patient preference, and other unknown confounders might have played a role in the observed disparity, it is still unclear whether overestimating the postoperative eGFR of Black patients contributes to the lower use of nephron-sparing approaches in this population,” the authors write.

"Augmented biopsy-based and noninvasive options are available to reduce benign resection rates of renal tumors with the consideration of PEER and 99mTc-sestamibi SPECT/CT," writes Hiten D. Patel, MD, MPH.

As the year comes to a close, we revisit some of this year’s top content on kidney cancer.

The FDA’s Fast Track Designation is designed to expedite the review and development of novel treatments that will fill an unmet medical need.

"What was surprising to me is that the incidence [of kidney cancer] has leveled off over the past 2 years," says Laura Bukavina, MD, MPH.

“Due to the rarity and poor molecular characterization of nccRCC, there is an underrepresentation in clinical trials evaluating patients with this type of RCC; because of this, patients are often treated with non-tailored therapies,” the researchers wrote.

Findings shared during the 2022 International Kidney Cancer Symposium showed that patients with advanced renal cell carcinoma treated upfront with pembrolizumab plus lenvatinib were far less likely to need second-line therapy vs patients receiving first-line sunitinib.

The updated results were shared at the 2022 International Kidney Cancer Symposium.

“The association between CKD and end-stage renal failure and increasing risk of kidney cancer is a really striking and important association to be aware of,” says Sarah P. Psutka, MD, MS.

"Up-front CN is associated with a survival benefit in selected patients with mRCC treated with either targeted therapy or ICI therapy," writes Badar M. Mian, MD.

“We really need to understand patient selection and treatment sequencing,” says Rana McKay, MD.

Rana McKay, MD, says that given the frontline shift from anti-VEGF monotherapy to immunotherapy doublets for advanced renal cell carcinoma, many of the studies informing the second-line setting have become “somewhat antiquated.”

Rana McKay, MD, says the CheckMate-214, KEYNOTE-426, CheckMate-9ER, and CLEAR trials have revolutionized the first-line treatment paradigm in advanced renal cell carcinoma.