Dr. Rini Discusses Pembrolizumab Plus Axitinib in mRCC

Brian I. Rini, MD, professor of medicine, Cleveland Clinic, discusses the combination of pembrolizumab (Keytruda) plus axitinib (Inlyta) in the treatment of patients with metastatic renal cell carcinoma (mRCC).

KEYNOTE-426, which was one of the more highly anticipated studies presented at the 2019 Genitourinary Cancers Symposium, was a global, randomized study looking at the combination of axitinib, a highly potent VEGF TKI, with the PD-1 inhibitor pembrolizumab. This combination had shown promise in an earlier phase Ib study (NCT02133742). As such, a randomized phase III trial was initiated, in which the combination was compared with sunitinib (Sutent) monotherapy.

The results were extremely impressive, with an unprecedented hazard ratio for survival of 0.53. Data also showed an improvement in progression-free survival (PFS) and overall response rates. The PFS was the longest reported at over 15 months and the response rate was the highest reported at nearly 60%. Rini concludes that this combination will become one of the preferred frontline standards of care in this space.

In April 2019, the FDA approved the combination of pembrolizumab plus axitinib for the frontline treatment of patients with mRCC.