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Updated European Association of Urology guidelines on renal cell carcinoma: Nivolumab plus cabozantinib joins immune checkpoint inhibition combination therapies for treatment-naïve metastatic clear-cell renal cell carcinoma

  • Jens Bedke,
  • Laurence Albiges,
  • Umberto Capitanio,
  • Rachel H. Giles,
  • Milan Hora,
  • Thomas B. Lam,
  • Börje Ljungberg,
  • Lorenzo Marconi,
  • Tobias Klatte,
  • Alessandro Volpe,
  • Yasmin Abu-Ghanem,
  • Saeed Dabestani,
  • Sergio Fernández Pello,
  • Fabian Hofmann,
  • Teele Kuusk,
  • Rana Tahbaz,
  • Thomas Powles,
  • Axel Bex

Publication: European Urology, December 2020

Longer follow-up and new trial data from phase 3 randomised controlled trials investigating immune checkpoint blockade (PD-1 or its ligand PD-L1) in advanced clear-cell renal cell carcinoma (RCC) have recently become available. The CheckMate 9ER trial demonstrated an improved progression-free survival (PFS) and overall survival (OS) benefit for the combination of cabozantinib plus nivolumab. A Keynote-426 update demonstrated an ongoing OS benefit for pembrolizumab plus axitinib in the intention-to-treat population, with a PFS benefit seen across all International Metastatic Database Consortium (IMDC) subgroups, while an update of CheckMate 214 confirmed the long-term benefit of ipilimumab plus nivolumab in IMDC intermediate and poor risk patients. The RCC Guidelines Panel continues to recommend these tyrosine kinase inhibitors + immunotherapy (IO) combination across IMDC risk groups in advanced first-line RCC and dual immunotherapy of ipilimumab and nivolumab in IMDC intermediate and poor risk.

Tags: Guidelines