Tian Zhang, MD, assistant professor of medicine, Duke University School of Medicine, Duke Cancer Institute, discusses the tolerability of agents used for the treatment of patients with renal cell carcinoma (RCC).

Patients have tolerated immunotherapy very well in RCC, explains Zhang. There are current ongoing phase III trials investigating immunotherapy in combination with VEGF inhibitors randomized against sunitinib (Sutent) in the first-line setting.

Most of these trials have completely enrolled and are awaiting final results which will determine tolerability, explains Zhang.

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Dr. Zhang on Toxicities of Treatments in RCC

Tian Zhang, MD, assistant professor of medicine, Duke University School of Medicine, Duke Cancer Institute, discusses the importance of clinical trials in the adjuvant setting of renal cell carcinoma (RCC).

Although the utility of adjuvant therapy in the treatment of RCC is still contested, Zhang says that participation in clinical trials is beneficial.

Adjuvant therapy may delay time to disease recurrence, and in a setting where there is no standard of care, Zhang encourages community urologists and primary care physicians to recommend their patients to clinical trials of adjuvant therapy.

Tian Zhang, MD, assistant professor of medicine, Duke University School of Medicine, Duke Cancer Institute, discusses the importance of clinical trials in the adjuvant setting of renal cell carcinoma.

Dr. Zhang on the Importance of Adjuvant Clinical Trials in RCC

Tian Zhang, MD, assistant professor of medicine, Duke University School of Medicine, Duke Cancer Institute, discusses the KEYNOTE-564 trial in renal cell carcinoma (RCC).

KEYNOTE-564 is an ongoing trial that is randomizing patients to pembrolizumab (Keytruda) or placebo, with a primary endpoint of disease-free survival.

This trial is enrolling high-risk patients with RCC, says Zhang, but it will also enroll patients with metastatic disease and have had metastasectomies—which is a unique feature of KEYNOTE-564.

Tian Zhang, MD, assistant professor of medicine, Duke University School of Medicine, Duke Cancer Institute, discusses the KEYNOTE-564 trial in renal cell carcinoma.
 

Dr. Zhang Discusses the KEYNOTE-564 Trial in RCC

Tian Zhang, MD, assistant professor of medicine, Duke University School of Medicine, Duke Cancer Institute, discusses the ARCHES study for patients with prostate cancer.

The ARCHES trial is investigating enzalutamide (Xtandi) in the maintenance setting for patients with metastatic castration-sensitive disease.

It is enrolling patients with metastatic castration-sensitive prostate cancer and randomizes them to either enzalutamide or placebo. The standard of care for these patients was androgen deprivation therapy alone before the LATITUDE or CHAARTED data was published, explains Zhang.

Dr. Zhang on the ARCHES Trial in Prostate Cancer

Tian Zhang, MD, assistant professor of medicine, Duke University School of Medicine, Duke Cancer Institute, discusses the impact of the STAMPEDE trial in prostate cancer.

The STAMPEDE trial compared abiraterone acetate (Zytiga) to androgen deprivation therapy (ADT) in patients with metastatic and nonmetastatic prostate cancer.

Early disease-free survival benefits are being seen with abiraterone acetate in the nonmetastatic setting, suggesting it could be a marker for overall survival benefit, says Zhang.

Dr. Zhang Discusses the Impact of the STAMPEDE Trial in Prostate Cancer

Tian Zhang, MD, a medical instructor in the Department of Medicine, Duke University School of Medicine, discusses the impact of the LATITUDE study in prostate cancer.

Median progression-free survival and overall survival were both markedly improved with the addition of abiraterone acetate (Zytiga) to standard androgen-deprivation therapy (ADT) compared with ADT alone in patients with newly diagnosed, high-risk, metastatic prostate cancer.

Dr. Zhang on the Impact of the LATITUDE Study in Prostate Cancer

Tian Zhang, MD, a medical instructor in the Department of Medicine, Duke University School of Medicine, discusses some of the challenges associated with administering vaccines to patients with renal cell carcinoma (RCC).

One of the main challenges in vaccine development is selecting tumor antigens versus personalizing and targeting them to the patient, explains Zhang. Additionally, she says that the bar continues to get higher and higher for first-line treatment of patients with metastatic RCC. Thus, in both ongoing trials and in the design of future studies, first-line therapies and their corresponding comparison arms will continue to change.

Zhang also emphasizes the importance of choosing the appropriate disease state in which to use the vaccine. Questions remain about whether to introduce vaccines in the adjuvant setting or in the first-line setting for metastatic disease.

She goes on to ask whether vaccines are somewhat of a lost cause, or if they represent a step forward in the treatment landscape of RCC. As researchers in the field continue to get better at designing these vaccines, Zhang says this is likely a step forward in improving immunotherapy for the treatment of patients with kidney cancer.

Tian Zhang, MD, a medical instructor in the Department of Medicine, Duke University School of Medicine, discusses some of the challenges associated with administering vaccines to patients with renal cell carcinoma.

Tian Zhang, MD, MHS, UT Southwestern Medical Center

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