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First-Line Treatment With Atezolizumab Plus Bevacizumab Versus Sunitinib in Kidney Cancer

By: Sara Tewksbury
Posted: Monday, July 22, 2019

Patients with PD-L1–positive metastatic renal cell carcinoma, which have not been previously treated, may benefit from combined treatment of atezolizumab plus bevacizumab. The phase III IMmotion151 trial, conducted by Brian Rini, MD, of the Taussig Cancer Institute, Cleveland Clinic, and colleagues, found that patients treated with atezolizumab plus bevacizumab had prolonged progression-free survival compared with those treated with sunitinib alone. Their findings were published in The Lancet.

“Longer-term follow-up is necessary to establish whether a survival benefit will emerge,” the investigators noted. “These study results support atezolizumab plus bevacizumab as a first-line treatment option for selected patients with advanced renal cell carcinoma.”

There were 915 patients enrolled in the multicenter open-label, randomized controlled trial. A total of 454 were randomly assigned to receive treatment with atezolizumab plus bevacizumab and 461, sunitinib.

Of the participants, 40% (362 patients) had PD-L1–positive disease (with about half receiving atezolizumab/bevacizumab and half receiving sunitinib). In this group, the median progression-free survival was 11.2 months with the combined therapy and 7.7 months with sunitinib alone. Although the overall survival results did not cross the boundary of significance at the interim analysis, the median overall survival in the intent-to-treat population was 33.6 months with the doublet and 34.9 months with sunitinib.

Treatment-related grade 3 or 4 adverse effects were reported in 40% of the combined treatment group and 54% of the sunitinib treatment group. The most common grade 3 or 4 adverse events in both groups was hypertension (14% with the doublet and 17% with sunitinib).

Disclosure: The study authors’ disclosure information may be found at thelancet.com.



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