Key Take Home Messages
- •Over the past few years, multiple new options have emerged for the treatment of patients with intermediate/poor-risk metastatic metastatic renal cell carcinoma (RCC), specifically ipilimumab/nivolumab (IO/IO) and multiple immunotherapy/tyrosine kinase inhibitor (IO/TKI) combinations (e.g. pembrolizumab/axitinib, nivolumab/cabozantinib). There have been no validated biomarkers, or a phase III trial, to guide selection between IO/IO vs. IO/TKI.
- •We performed an electronic survey-based study to evaluate whether oncologists prefer IO/IO vs. IO/TKI for patients with intermediate/poor-risk metastatic RCC and what factors go into their decision-making.
- •We sent 294 surveys and received 105 responses (36% response rate). 61% of providers chose IO/IO, 39% chose IO/TKI. 78% of oncologists were academic or disease-focused, 22% were general. Academic/GU-focused oncologists were significantly more likely to choose IO/IO (56/82, 68%) compared to general oncologists (8/23, 35%), P = .004.
- •The majority of oncologists noted toxicity to play a role in their decision-making. Despite the significant treatment preference among academic/GU oncologists, the majority of respondents felt comfortable enrolling patients into a phase III trial comparing IO/IO vs. IO/TKI, demonstrating continued equipoise surrounding this question in the community.
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- Nivolumab plus ipilimumab versus sunitinib in advanced renal-cell carcinoma.N Engl J Med. 2018;; 378: 1277-1290
- Pembrolizumab plusaxitinib versus sunitinib for advanced renal-cell carcinoma.N Engl J Med. 2019;; 380: 1116-1127
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Study of cabozantinib in combination with nivolumab and ipilimumab in patients with previously untreated advanced or metastatic renal cell carcinoma (COSMIC-313). Available at: https://clinicaltrials.gov/ct2/show/NCT03937219. Accessed March 22, 2022.
Immunotherapy with nivolumab and ipilimumab followed by nivolumab or nivolumab with cabozantinib for patients with advanced kidney cancer, the PDIGREE study. Available at: https://clinicaltrials.gov/ct2/show/NCT03793166. Accessed March 22, 2022.
Study has been presented at: International Kidney Cancer Symposium (IKCS), Austin, TX, 11/2021
Society for Immunotherapy for Cancer (SITC), Washington, DC, 11/2021