Dr. McDermott on Toxicities of Immunotherapy Combinations in RCC

David F. McDermott, MD, director of the Biologic Therapy and Cutaneous Oncology Programs at Beth Israel Deaconess Medical Center, professor of medicine, Harvard Medical School, discusses the toxicities associated with immunotherapy combinations in renal cell carcinoma (RCC).

The toxicities associated with immune-based combinations in RCC are similar to those seen in other tumor types, says McDermott.

In the case of PD-1/VEGF combinations, which are fairly unique to kidney cancer, an amplification in adverse events (AEs) is not typically observed, says McDermott; however, there are chronic toxicities, particularly with VEGF inhibition, which is often administered for a long period of time.

These chronic AEs may impact a patient’s quality of life and lead to treatment discontinuation, says McDermott. While the addition of a CTLA-4 inhibitor to a PD-1 inhibitor is thought to improve the durability of response, it also adds toxicity, says McDermott.

In RCC, a higher dose of PD-1 blockade and a lower dose of CTLA-4 blockade has shown reduced toxicity and sustained efficacy, says McDermott.