Xiao X. Wei, MD, MAS, instructor of medicine, Harvard Medical School, Dana-Farber Cancer Institute, discusses immune-related adverse events (irAE) in genitourinary (GU) cancers.

PD-1/PD-L1 inhibitors are generally well tolerated in patients with GU cancers. Wei says clinicians do need to be on the lookout for irAEs, as it is not fully understood who experiences them or why. The faster that an irAE is treated, the better the outcome, Wei adds. The common organs that are effected by irAEs are the skin, gastrointestinal tract, liver, and the endocrine system.

There is no prospective data or high-level evidence to suggest how to treat irAEs, but ASCO, NCCN, and ESMO have all released guidelines regarding the management of patients who experience these events within the last few years. Clinicians should refer to these guidelines when managing patients on immunotherapy.

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Xiao X. Wei, MD, MAS, instructor of medicine, Harvard Medical School, Dana-Farber Cancer Institute, discusses immune-related adverse events (irAE) in genitourinary (GU) cancers.
 

Dr. Wei on Immune-Related Adverse Events in GU Cancers

Xiao X. Wei, MD, MAS, instructor of medicine, Harvard Medical School, Dana-Farber Cancer Institute, discusses the side effect profile of cabozantinib (Cabometyx) in advanced kidney cancer.

Cabozantinib has a relatively similar side effect profile compared with the other tyrosine kinase inhibitors like sunitinib (Sutent) and pazopanib (Votrient). Data from the CABOSUN study compared cabozantinib with sunitinib, so physicians have an idea of how the 2 agents are side by side. The randomized phase II trial of 157 patients compared the 2 agents on the regular 4/2 dose schedule. The primary endpoint of investigator assessment response was met at 8.2 months versus 5.6 months respectively. The overall survival data, at a median follow-up of 20 months or more, favored cabozantinib.

Diarrhea is much more frequently seen with cabozantinib, states Wei. It’s the most common reason why patients require a dose reduction. When physicians use cabozantinib to treat patients with advanced kidney cancer, they should be ready to hold the agent and reduce the dose if necessary.

Xiao X. Wei, MD, MAS, professor of medicine, Harvard Medical School, Dana-Farber Cancer Institute, discusses the side effect profile of cabozantinib (Cabometyx) in advanced kidney cancer.

Xiao X. Wei, MD

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Dr. Wei on Immune-Related Adverse Events in GU Cancers

Dr. Wei on the Use of Cabozantinib in Advanced Kidney Cancer