Dr. Shuch on Caveats of Avelumab/Axitinib Combination in RCC

Brian M. Shuch, MD, director, Kidney Cancer Program, Alvin & Carrie Meinhardt Endowed Chair of Kidney Cancer Research, University of California, Los Angeles Institute of Urologic Oncology, discusses caveats of the avelumab plus axitinib combination in frontline advanced renal cell carcinoma.

Brian M. Shuch, MD, director, Kidney Cancer Program, Alvin & Carrie Meinhardt Endowed Chair of Kidney Cancer Research, University of California, Los Angeles Institute of Urologic Oncology, discusses caveats of the combination of avelumab (Bavencio) and axitinib (Inlyta) in frontline advanced renal cell carcinoma (RCC).

Data from the JAVELIN Renal 101 trial which showed an improvement in median progression-free survival with the combination versus sunitinib (Sutent), were striking, Shuch notes. However, sunitinib has been shown to be inferior to several different combinations, including ipilimumab (Yervoy) plus nivolumab (Opdivo) and pembrolizumab (Keytruda) plus axitinib. Single-agent cabozantinib (Cabometyx) has also shown superiority to sunitinib.

Notably, there are still no overall survival (OS) data with avelumab plus axitinib, whereas the other frontline combinations have promising OS data. As such, it would be hard to justify using avelumab plus axitinib versus these other combinations until OS data are published, says Shuch.

In May 2019, the FDA approved avelumab and axitinib for the frontline treatment of patients with advanced RCC.