Reporting from results of a phase 3 clinical trial, patients with metastatic kidney cancer may soon receive a new standard treatment involving a combination of two drugs. The drugs, axitinib plus the immunotherapeutic agent avelumab, were seen to significantly decrease tumor size better that the current treatment involving the drug sunitinib (Sutent), used specifically in the treatment of renal cell carcinoma.
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"Patients receiving the drug combination also had a higher response rate -- meaning their tumors shrank -- than the sunitinib-only group," says Toni K. Choueiri, MD, senior and co-corresponding author of the report and The Jerome and Nancy Kohlberg Professor of Medicine at Harvard Medical School. "This is certainly better than sunitinib -- hopefully this will lead to Food and Drug Administration approval soon.”
The drug combination, particularly involving the immunotherapeutic—avelumab, works by not only targeting the vascular endothelial growth factor receptor (VEGFR) to disrupt the blood supply to tumors but by also inhibiting and immune checkpoint called PD-L1 which naturally works to exhausts immune T cells—this will ensure the effective attack of cancer cells.
"Interestingly, the analysis showed that all subgroups -- good, intermediate, and poor-risk patient -- benefited from the combination treatment," said Choueiri. This was the topic of an oral presentation Choueiri has just given at the 2019 Genitourinary Cancers Symposium in San Francisco. The results were simultaneously published in the New England Journal of Medicine.
Almost all patients in the study experienced some form of side effects—with the most frequent being thyroid disorders in the drug combination group. However, Dr. Choueiri states that for patients with advanced stage of cancer, the drug combination will serve as "an important option. What we're doing in advanced kidney cancers is pushing the envelope -- these treatments may not be curative, but patients are living longer, and the disease is becoming more chronic."
Source: Dana-Farber Cancer Institute
