Reassessing the Value of IO Treatment as the ‘Fifth Pillar’ of Cancer Therapy
One of the phrases integrated into our lexicon over the last several years suggests that immuno-therapy (IO) has become the ‘fifth pillar’ of cancer therapy—enhancing the first four of surgery, chemotherapy, radiotherapy and targeted therapy. If IO is the fifth pillar in that regard, then in the treatment of renal cell carcinoma (RCC), it is now the cornerstone as new regimens vie for the frontline space in metastatic RCC.
While the field of IO has advanced significantly, supported by pivotal trials like JAVELIN Renal 101, CheckMate-214, and KEYNOTE-426, much more knowledge is needed to achieve a future where the potential benefit of these therapies can be maximized for the greatest number of patients. Key questions remain about how to select those patients who are most likely to respond to IO therapy, how to combine IO therapies with one another and with other treatment modalities, how to predict, limit, and mitigate IO treatment related toxicities, how to reduce resistance to IO therapies, how to use these therapies in newly defined standards of care and when to stop treatment. Some of these questions are addressed in this issue’s Round Table discussion with three experts whose knowledge of the pivotal IO studies offers key perspectives on the IO-TKI combinations promoted as part of the standard of care. (continue)
Flare Phenomenon or Pseudoprogression
During ICI Therapy in RCC: Potential Value of Treatment Beyond First Progression
Saby George, MD
Associate Professor
Department of Medicine
Roswell Park Cancer Institute
Buffalo, New York Read
Targeting Glutamine Metabolism:
the CANTATA Trial for Patients With Metastatic Renal Cell Carcinoma (mRCC)
Andrew W. Hahn, MD and
Nizar M. Tannir, MD, FACP
Department of Genitourinary Medical Oncology
Division of Cancer Medicine
MD Anderson Cancer Center
Houston, TX Read
Reality Check: What Is the Latest Paradigm
for Cytoreductive Nephrectomy vs Targeted Therapy in mRCC?
Petar Bajic, MD
Fellow, Division of Urology
Rush University Medical Center
Chicago, Illinois
Robert C. Flanigan, MD
Professor, Department of Urology
Loyola University Chicago Stritch School of Medicine
Maywood, Illinois Read
ROUNDTABLE
Deconstructing IO Therapy:
Three Combinations, Three Viewpoints from
Key Opinion Leaders
Rana Mckay, MD1
Matthew Milowsky, MD2
Thomas Powles, FRCP3
- 1
- 2
- 3 Barts Cancer Institute, London, England. Read
Inaugural RCC ‘Think Tank’ Could
Refocus Kidney Cancer Research
The Kidney Cancer Association (KCA) is launching “Think Tank: Coalition for a Cure” at this year’s International Kidney Cancer Symposium (IKCS). This first-of-its-kind event will be a unique opportunity for the experts and advocates who gather from across the globe to learn from one another and discuss the complexities of renal cell carcinoma (RCC).
Two of the KCA’s Medical Steering Committee members, Bradley Leibovich, MD, and Brian I. Rini, MD, will moderate the Think Tank, which takes place on November 14, the evening before the IKCS begins.
Key goals for the discussion include:
- Identification of the most current and important questions regarding advances and new approaches that could potentially change the treatments and outcomes for current RCC patients.
- Identification of the greatest unmet needs in kidney cancer research to help all within the RCC space eliminate overlaps in funding efforts. (continue)
Essential Peer-Reviewed Reading in Kidney Cancer
The peer-reviewed articles summarized in this section were selected by the Editor-in-Chief, Robert A. Figlin, MD, for their timeliness, importance, relevance,and potential impact on clinical practice or translational research.
Clinicopathologic features associated with survival after cytoreductive nephrectomy for nonclear cell renal cell carcinoma. Silagy AW, Flynn J, Mano R, et al. Urol Oncol. 2019 Sep 12. pii: S1078-1439(19)30287-X. doi: 10.1016/j.urolonc. 2019. 07.011.[Epub ahead of print]
Summary: Resultd are based on a prospectively maintained database for patients who underwent CN for nccRCC between 1989 and 2018. Histology was reviewed by an expert genitourinary pathologist, and nccRCC tumors were subdivided into papillary, unclassified, chromophobe, and other histology. Baseline
clinicopathology, treatments, and survival outcomes were recorded. Preoperative hematological parameters including the neutrophil-to-lymphocyte ratio (NLR) were. (continue)
Newsworthy, late-breaking information from Web-based sources, professional societies, and government agencies
Positive Topline Results Achieved in
Randomized Phase 2 ENTRATA Study of
Telaglenastat with Everolimus in RCC
• Doubled median progression-free survival
(PFS) in heavily pre-treated patients with
advanced renal cell carcinoma
• Provides first clinical proof of concept for
glutaminase inhibitor telaglenastat
SOUTH SAN FRANCISCO, CA—Calithera Biosciences has achieved positive results from its randomized placebo-controlled Phase 2 ENTRATA study of telaglenastat (CB-839) in combination with everolimus in patients with advanced RCC. The combina-tion doubled the median progression-free survival (PFS) in heavily pre-treated patients with advanced RCC and had a well-tolerated safety profile. Telaglenastat is the first glutaminase inhibitor to demonstrate clinical activity for the treatment of cancer. (continue)
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