A combination of immunotherapy and targeted therapy may prove more effective in fighting advanced kidney cancers, according to two new studies presented at ASCO-GU.
Two separate new studies published on Saturday February 16 in the New England Journal of Medicine and presented at the congress presented at the congress ASCO-GU 2019 bring encouraging results in the treatment of metastatic kidney cancer.
The first study is a phase 3 clinical trial conducted by the Dana-Farber Cancer Institute (Boston, USA). It shows that the combination of immunotherapy avelumab, combined with targeted treatment axitinib (anti-VEGF) could become a new standard of first-line treatment in patients suffering from metastatic kidney cancer.
Reduction of tumors
The work involved 886 patients with kidney cancer. Among them, 442 received avelumab (an anti-PD-L1 immunotherapy) and axitinib as treatment, and 444 received sunitinib, a first-generation anti-VEGF for the treatment of metastatic kidney cancer.
Patients who received the combination had a significant advantage in progression-free survival over those treated with monotherapy. The study showed that the average progression-free survival was 13.8 months in patients treated with avelumab and axitinib, compared to 7.2 months in those treated with sunitinib.
“Patients receiving the combination drug also had a higher response rate—meaning their tumors shrank—compared to those in the group receiving only sunitinib,” explained Toni K. Choueiri, MD, lead research author. appeared in the New England Journal of Medicine.
47% lower risk of death
The second study, also published in the NEJMtested two modes of treatment on a cohort of 861 patients with kidney cancer: the first with a combination of pembrolizumab (anti-PD-L1 immunotherapy) and axitinib and the second with suninib only.
Of the patients who participated in the study, 432 received intravenous pembrolizumab and axitinib as treatment, and 429 received sunitinib. The results show that the mean progression-free survival of the disease is 15.1 months in the pembrolizumab-axitinib group compared to 11.1 months in the patients treated with sunitinib.
Patients who received the pembrolizumab-axitinib combination treatment therefore have a 47% lower risk of death and a 31% lower risk of disease progression than those who received sunitinib.
Further research is needed
These two studies therefore have similar results, namely that the combination treatments significantly improve the chances of survival and stop the progression of the disease more than the monotherapy treatments. This new lead is therefore promising, even if the combined treatments tested in these two studies are not yet approved by the Food and Drug Administration for renal cell cancer.
For Dr. Bernard Escudier, former president of the genito-urinary group at the Institut Gustave Roussy in France, who published an editorial in the NEJM about these 2 new works: “These two combinations should become new standards of care and be incorporated into future guidelines.”
It remains to be seen whether the effectiveness of these treatments is confirmed in the long term. Experts therefore stress the need to follow patients for longer, as well as to conduct more in-depth research on the overall way in which immunotherapies influence treatment approaches.
.
