Ipilimumab Plus Nivolumab vs. Sunitinib in Metastatic Kidney Cancer
Brian I. Rini, MD, of the Cleveland Clinic Taussig Cancer Center, discussed the reasons why ipilimumab/nivolumab may be considered a standard in the front-line treatment of patients with metastatic renal cell carcinoma, at the 2017 International Kidney Cancer Symposium. He shared evidence from CheckMate 214 of significantly higher complete response and partial response rates with durability in patients who received the combination therapy compared with those who received sunitinib.
More than 1,000 patients with advanced or metastatic renal cell carcinoma were randomized 1:1 to receive ipilimumab plus nivolumab or sunitinib. Primary endpoints were complete response rates in intermediate/poor-risk patients.
The doublet therapy arm showed higher complete response rates than sunitinib (9% vs 1%). The combination therapy group also showed a higher partial response rate of 32% versus 25% with the single therapy. According to Dr. Rini’s clinical experience, a number of these partial response rates will be “significant, meaning deep and durable, with 80% to 90% tumor shrinkage.”
As for those with intermediate/poor-risk disease, the combination therapy produced about a 3-month advantage over sunitinib alone (11.6 vs. 8.4 months) in progression-free survival, although this result did not meet the statistical threshold. In this subset of patients, overall survival also favored the combination therapy. However, Dr. Rini added, “when you give this regimen to an all-comer population, there is a significant survival advantage.”