Neil J. Shah, MBBS, discusses unmet needs for patients with renal cell carcinoma (RCC) receiving immune-oncology (IO)–based combinations in the frontline setting.

Dr Shah on Remaining Unmet Needs in RCC After Frontline IO Combinations

Neil J. Shah, MBBS, assistant attending physician, genitourinary oncologist, Memorial Sloan Kettering Cancer Center, discusses unmet needs for patients with renal cell carcinoma (RCC) receiving immune-oncology (IO)–based combinations in the frontline setting.

Most patients with advanced RCC will receive an IO/IO or IO/TKI combination in the frontline setting, but unmet needs remain for these patients. Shah and coauthors presented a real-world study during 2024 Kidney Cancer Research Summit, which demonstrated that patients with RCC who received various IO/IO and IO/TKI combinations all experienced similar outcomes, and there is limited overall survival in the post-IO/IO and -IO/TKI setting, underscoring the need for the development of more novel therapies in the space.

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Neil J. Shah, MBBS, discusses unmet needs for patients with RCC receiving immune-oncology–based combinations in the frontline setting.

Neil Shah, MD, PhD, professor, Department of Medicine (Hematology/Oncology), University of California, San Francisco (UCSF) Program Leader, Hematopoietic Malignancies Program, UCSF Helen Diller Family Comprehensive Cancer Center, discusses investigational agents in chronic myeloid leukemia (CML).

Two of the more mature investigational agents in CML are ABL001, also known as asciminib, and PF-114; both of these agents have promise. PF-114 is slightly more traditional in its composition and binds where the other TKIs bind, explains Shah, while ABL001 is more of a novel agent. Nonetheless, if both agents show a clean safety profile, they are likely to progress in development.

As it stands, patients have access to 4 frontline treatment options. The majority of patients will be able to identify 1 agent that is effective and tolerable, says Shah, and as a result, the prognosis of the disease is very positive. The majority of patients are more likely to die from causes completely unrelated to CML and its therapies rather than the disease itself, he concludes.

Dr. Shah on Investigational Agents in CML

Neil Shah, MD, PhD, professor, Department of Medicine (Hematology/Oncology), University of California, San Francisco (UCSF) Program Leader, Hematopoietic Malignancies Program, UCSF Helen Diller Family Comprehensive Cancer Center, discusses frontline treatment considerations for patients with chronic myeloid leukemia (CML).

For many years, there have been 3 frontline options for the treatment of patients with CML. In December 2017, the FDA granted an accelerated approval to bosutinib (Bosulif) as a first-line treatment for patients with Philadelphia chromosome-positive CML. This approval was based on findings from the phase III BFORE trial, which showed that the major molecular response at 12 months was 47.2% with bosutinib (95% CI, 40.9-53.4) compared with 36.9% (95% CI, 30.8-43.0) for imatinib (Gleevec).

This was a 2-year follow-up, which Shah says provided a sense of how well tolerated bosutinib is compared with imatinib. Toxicities remain though, including gastrointestinal issues and thrombotic events. Shah says that it is too early to know if it is going to improve overall survival. Nonetheless, he says it is looking favorable in terms of response compared with imatinib.

Neil Shah, MD, PhD, professor, Department of Medicine (Hematology/Oncology), University of California, San Francisco (UCSF) Program Leader, Hematopoietic Malignancies Program, UCSF Helen Diller Family Comprehensive Cancer Center, discusses frontline treatment considerations for patients with chronic myeloid leukemia. 
 

Neil Shah, MD, PhD

Articles

Dr Shah on Remaining Unmet Needs in RCC After Frontline IO Combinations

Dr. Shah on Investigational Agents in CML

Dr. Shah Discusses Frontline Considerations for the Treatment of CML