Dr. Joseph on the Combination of Atezolizumab and Bevacizumab in mRCC

Richard W. Joseph, MD, internist and oncologist, Mayo Clinic, discusses the combination of atezolizumab (Tecentriq) and bevacizumab (Avastin) in metastatic renal cell carcinoma (mRCC).

The combination of atezolizumab and bevacizumab has shown encouraging signals of activity, according to results from the phase II IMmotion150 and the phase III IMmotion151 trials. However, the primary endpoints are relatively immature. Joseph, having treated patients on the trials, explains that the combination is also 1 of the more tolerable regimens of the combinations available for patients with advanced RCC. The rate of grade 3/4 adverse events tends to be on the lower side with atezolizumab and bevacizumab compared with other combinations.

That combination, pending approval, is likely to have a prominent role in patients who are frailer and in whom maintaining a good quality of life is more of a goal, says Joseph. The complete response rates with this combination look pretty reasonable, too. If the combination is approved, it is likely to complicate the current paradigm, of which there are currently 3 combination therapies to choose from. However, another option is always a good thing for patients, concludes Joseph.