PARP inhibitors, vaccines and combination therapies for kidney cancer

In this interview with OncLive, professor Sumanta Kumar Pal from City of Hope Hospital in California discusses the potential of poly ADP ribose polymerase (PARP) inhibitors, chimeric antigen receptor (CAR)-based products, vaccines, and novel drug combinations for the treatment of metastatic renal cell carcinoma (mRCC).

Results from the phase Ib/II TiNivo study of the combination of tivozanib and nivolumab have demonstrated a 56% overall response rate, including 1 complete response, 12 confirmed partial responses, and 1 unconfirmed partial response, in 25 patients with metastatic RCC who received the combination. The disease control rate was 96% and progression-free survival (PFS) was 18.9 months. Other combinations already on the market include ipilimumab/nivolumab, avelumab/axitinib and pembrolizumab/axitinib, all for the first-line treatment of mRCC. Sequencing of these combinations remains a challenge for clinicians.

Professor Pal then went on to discuss the potential utility of PARP inhibitors for metastatic RCC, local delivery of treatments directly into the kidneys, CAR-T cell therapy and vaccines for metastatic RCC. Professor Pal ended by saying that clinicians may need to start looking at non-inferiority studies or studies based on endpoints, such as quality of life and patient-reported outcomes to differentiate between treatments. Outcomes for patients with kidney cancer have dramatically improved with new treatments, but there is still a long way to go in terms of managing adverse events.

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