Dr. Powles on the Results of the KEYNOTE-426 Trial in mRCC

Thomas Powles, MBBS, MRCP, MD, director, Barts Cancer Institute, discusses the results of the KEYNOTE-426 trial in metastatic renal cell carcinoma (mRCC).

KEYNOTE-426 showed that the combination of pembrolizumab (Keytruda) and axitinib (Inlyta) was superior to sunitinib (Sutent) monotherapy in patients with metastatic clear cell RCC, says Powles. The survival benefit translated to a risk reduction of 47% (HR, 0.53; 95% CI, 0.38-0.74; P <.0001). Though, the median overall survival was not reached in either arm. That's an unprecedented survival advantage in this setting, adds Powles.

This study speaks to the power of combining a VEGF inhibitor and a PD-1 inhibitor. Historically, the trials that were conducted with sunitinib only showed a benefit in progression-free survival. Although the VEGF-targeted therapies have moved the field forward steadily over the years, physicians have not seen such a dramatic improvement in survival in the frontline setting. These results will have an immediate impact on the way physicians think about kidney cancer, concludes Powles.