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RENAL CELL CARCINOMA IN 2018

Radical shifts in the first-line management of metastatic renal cell carcinoma

Nature Reviews Clinical Oncology volume 16, pages 71–72 (2019)Cite this article

Subjects

In 2018, the results of multiple phase III trials in metastatic renal cell carcinoma (mRCC) were presented. A phase III noninferiority trial demonstrated the importance of careful patient selection before cytoreductive nephrectomy. Additionally, three randomized phase III trials demonstrated the superiority of combination therapy with an immune-checkpoint inhibitor backbone versus sunitinib in patients with treatment-naive mRCC.

Key advances

  • Careful patient selection is critical for patients with metastatic renal cell carcinoma (mRCC) being considered for cytoreductive nephrectomy and should be discouraged in patients with poor-risk mRCC who have a high burden of extrarenal disease4.

  • A phase III trial comparing ipilimumab and nivolumab versus sunitinib in first-line intermediate-risk and poor-risk mRCC demonstrated an overall survival benefit for patients receiving ipilimumab and nivolumab6.

  • Multiple phase III trials in treatment-naive mRCC demonstrated that the combination of immune-checkpoint inhibitors with VEGF-targeted agents is superior to VEGF-targeted therapy alone7,9.

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References

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Authors and Affiliations

  1. Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA

    Moshe C. Ornstein & Brian I. Rini

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  1. Moshe C. Ornstein
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  2. Brian I. Rini
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Correspondence to Brian I. Rini.

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Competing interests

M.C.O. has received fees as a consultant of Bristol-Myers Squibb, Exelixis, Eisai and Pfizer. B.I.R. has received fees as a consultant of Bristol-Myers Squibb, Merck and Pfizer.

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Ornstein, M.C., Rini, B.I. Radical shifts in the first-line management of metastatic renal cell carcinoma. Nat Rev Clin Oncol 16, 71–72 (2019). https://doi.org/10.1038/s41571-018-0146-4

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