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Jul 25, 2019

A virtual roundtable discussion with noted investigators Dr Toni K Choueiri and Prof Thomas Powles for a review of recent innovations in the treatment of renal cell carcinoma.

  • Risk stratification and selection of first-line therapy for metastatic renal cell carcinoma (mRCC) (00:00)
  • Role of cytoreductive nephrectomy in RCC (1:50)
  • Overall survival and complete response (CR) improvements with the FDA-approved nivolumab/ipilimumab combination versus sunitinib for intermediate- or poor-risk previously untreated advanced RCC on the Phase III CheckMate 214 trial (4:18)
  • Activity of nivolumab alone or in combination with ipilimumab for patients with mRCC and brain metastases (9:25)
  • Tolerability of nivolumab/ipilimumab; risk of immune-related adverse events (AEs) (11:21)
  • Recent FDA approvals of avelumab with axitinib (JAVELIN Renal 101) and pembrolizumab with axitinib (KEYNOTE-426) as first-line treatment for advanced RCC (13:24)
  • Comparison of cellular distribution, activity and tolerability of anti-PD-1 versus PD-L1 antibodies (14:14)
  • Similarities and differences in clinical outcomes among the JAVELIN Renal 101 (avelumab/axitinib) and KEYNOTE-426 (pembrolizumab/axitinib) trials (19:01)
  • Indirect comparison of the efficacy and tolerability of nivolumab/ipilimumab versus avelumab/axitinib and pembrolizumab/axitinib (26:35)
  • Importance of educating patients and community practitioners on the distinction between immune checkpoint inhibitor- and chemotherapy-related side effects (30:55)
  • Choosing among newly approved first-line therapeutic options for mRCC (ie, avelumab/axitinib, pembrolizumab/axitinib, nivolumab/ipilimumab); factors influencing whether to use a VEGF tyrosine kinase inhibitor (32:45)
  • Perspective on the results of the Phase III IMmotion151 trial: Atezolizumab with bevacizumab versus sunitinib in patients with previously untreated mRCC (37:16)
  • Ongoing investigation of anti-PD-1/PD-L1 antibody-based therapy in the (neo)adjuvant settings (41:17)
  • Toward increasing cure rates for patients with RCC (46:09)
  • Approach for patients with no evidence of disease after nephrectomy (50:36)
  • Predictors of benefit with immune checkpoint inhibitors and anti-angiogenic agents (53:16)
  • Case (Dr Choueiri): A man in his mid-60s with clear cell mRCC who receives nivolumab/ipilimumab and for whom nivolumab is held briefly because of a number of rare immune-related AEs ultimately attains a durable near CR (57:50)
  • Clinical experience with and management of rare immune-related AEs in patients receiving checkpoint inhibitors (1:01:11)
  • Case (Prof Powles): A woman in her early 30s with newly diagnosed intermediate-risk mRCC receives nivolumab/ipilimumab (1:09:02)
  • Case (Prof Powles): A man in his late 60s with intermediate-risk, clear cell mRCC experiences low-grade immune checkpoint inhibitor-associated side effects with nivolumab/ipilimumab (1:15:06)
  • Case (Dr Choueiri): A man in his mid-50s with clear cell mRCC receives avelumab/axitinib on a clinical trial (1:18:11)
  • Choosing between pembrolizumab/axitinib and avelumab/axitinib (1:23:18)

CME information and select publications