Dr. McKay on the shifting second-line paradigm in advanced renal cell carcinoma

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.