Research Highlights

Abstract

The introduction of immunotherapybased drug combinations has dramatically impacted the management of advanced renal cell carcinoma. Powles et al. recently reported interim data from the phase 3 randomised trial (KEYNOTE-426) that showed that the combination of pembrolizumab, an anti-PD-1 antibody and axitinib, a VEGFR inhibitor, appears to be superior to the traditional agent, sunitinib. The authors describe results from 861 patients with advanced renal cell carcinoma with clear cell histology who were randomized 1:1 between these two therapies. After a median follow-up of 30.6 months, the patients receiving the drug combination had a superior overall survival (not reached for pembrolizumab plus axitinib) vs 35.7 months for patients receiving sunitinib and a superior median progression-free survival of 15.4 months vs 11.1 months. Hypertension was the most frequent grade 3 or worse event occurring in 22% and 20% of patients, respectively. Other complications included an increase in alanine aminotransferase and diarrhoea. These results suggest that the combination of pembrolizumab and axitinib should be the new standard of care for advanced renal cell carcinoma.