Claud M. Grigg, Jr., MD, medical oncologist, Levine Cancer Institute-Ballantyne, Atrium Health, discusses the results of the CheckMate-214 trial in renal cell carcinoma (RCC).

The randomized phase 3 CheckMate-214 trial evaluated the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) versus sunitinib (Sutent) in patients with previously untreated advanced or metastatic RCC. The study was one of the first to assess the role of combination therapy in the frontline setting, says Grigg. In the experimental arm, 550 patients received 3 mg/kg of nivolumab plus 1 mg/kg of ipilimumab every 3 weeks for 4 doses, followed by 3 mg/kg of nivolumab every 2 weeks. In the control arm, 546 patients received 50 mg of oral sunitinib once daily for a total of 4 weeks, followed by 2 weeks off before treatment continuation, Grigg explains.

At 4 years of follow-up, results of the CheckMate-214 trial showed a median overall survival of 48.1 months with the combination compared with 26.6 months with sunitinib. Notably, the study has longer-term follow-up data versus many other trials in the space. To date, patients appear to have derived durable responses with the combination of nivolumab/ipilimumab, Grigg concludes.

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Claud M. Grigg, Jr., MD, discusses the results of the CheckMate-214 trial in renal cell carcinoma.
  


 Dr. Grigg on the Results of the CheckMate-214 Trial in RCC  

Claud M. Grigg Jr, MD, medical oncologist, Levine Cancer Institute-Ballantyne, Atrium Health, discusses sequencing challenges in renal cell carcinoma (RCC).

Although sequencing is a challenge, determining what agent to start a patient on in the frontline setting is proving to be even more difficult, says Grigg, particularly because clear cell RCC can manifest in many different clinical presentations. The disease can be very aggressive or very indolent, but physicians may not necessarily know that upfront. Learning how to risk-stratify patients from the outset and then how to choose the right therapy from the start based on efficacy and tolerability is key, adds Grigg.

The use of TKI monotherapy will not have as much of an impact on treatment moving forward as it once had in the past. Now, combinations of VEGF TKIs and immunotherapy are showing greater efficacy and are likely to take over the frontline setting for the majority of patients. Ultimately, time will tell, concludes Grigg.

Claud M. Grigg Jr, MD

Articles

Dr. Grigg on the Results of the CheckMate-214 Trial in RCC

Dr. Grigg on Sequencing in Renal Cell Carcinoma