Elizabeth Plimack, MD, Director of Genitourinary Clinical Research, Associate Professor, department of hematology/oncology, Fox Chase Cancer Center, discusses the role of nivolumab in kidney cancer.

We now have long-term follow-up data from patients that have been on nivolumab for four to five years, says Plimack. About one-third of patients are still alive at four years.

This long-term benefit occurred in patients regardless of their initial response to therapy and risk group.

Biomarker development is needed, and as well as research regarding adverse events and combination possibilities. A lot can still be learned regarding how nivolumab should be used in kidney cancer, says Plimack.

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Dr. Elizabeth Plimack on Nivolumab in Kidney Cancer

Elizabeth Plimack, MD, MS, Associate Professor, Director of Genitourinary Clinical Research at Fox Chase Cancer Center, discusses immunotherapy in bladder cancer.

PD-L1 and PD-1 inhibitors have shown activity in bladder cancers, says Plimack. Ipilimumab, a CTLA-4 targeting agent, also has potential, but it has not been tested as much as other immunotherapies have, she adds. At this point, the efficacy of ipilimumab by itself in bladder cancer is unknown. However, Plimack says the use of ipilimumab and other CTLA-4 targeting agents is worth investigating.

In lung cancer, PD-L1 and PD-1 inhibitors have been combined with chemotherapy, and some preliminary data has been recorded. Plimack feels that researchers can take that information and build upon it in bladder cancer.

Dr. Elizabeth Plimack on Immunotherapy Potential in Bladder Cancer

Elizabeth Plimack, MD, MS, attending physician, medical oncology, Fox Chase Cancer Center, discusses a phase I trial that looked at overcoming mTOR resistance with an HDAC inhibitor in renal cell carcinoma (RCC).

In this trial, patients received the mTOR inhibitor ridaforolimus in combination with the HDAC inhibitor vorinostat. Plimack says the rationale for this trial was to test the hypothesis that resistance to mTOR inhibitors can be overcome by HDAC inhibition. Currently, mTOR inhibitors are approved for the treatment of RCC, though resistance has been noted and some patients do not respond at all.

Plimack and other researchers thought to test this mechanism and determine which doses are safe and tolerable in combination. Ridaforolimus 20mg daily plus vorinostat 100 mg daily is the recommended phase II dose for this combination.

Elizabeth Plimack, MD

Articles

Dr. Elizabeth Plimack on Nivolumab in Kidney Cancer

Dr. Elizabeth Plimack on Immunotherapy Potential in Bladder Cancer

Dr. Plimack on an mTOR/HDAC Inhibitor Combination in RCC