Cancer Therapy AdvisorExploring First-Line Treatments: ASCO GU 2024 Update on Advanced Renal Cell Carcinoma

Advancements in aRCC Treatments: Unveiling Real-World Efficacy and Addressing Racial Disparities in Patient Outcomes

The latest findings from ASCO GU 2024 shed light on the evolving landscape of advanced renal cell carcinoma (aRCC) treatment, offering a comprehensive analysis of the efficacy of first-line therapies in real-world settings and underscoring the critical need to address racial disparities in patient outcomes. This summary distills the essence of these studies, providing physicians with crucial insights into the effectiveness of combination therapies and the factors influencing treatment disparities.

Key Points:

• Real-world studies confirm the efficacy of axitinib plus pembrolizumab (A+P) and avelumab plus axitinib (A+Ax) in treating aRCC, with outcomes comparable to those in phase 3 clinical trials.
• Pembrolizumab plus lenvatinib (P+L) is highlighted as an effective first-line treatment option, showing superior objective response rates (ORR) and progression-free survival (PFS) in network meta-analyses.
• Long-term data from the CheckMate 214 and CheckMate 9ER trials indicate sustained survival and response benefits with ipilimumab plus nivolumab (IPI+NIVO) and nivolumab plus cabozantinib (N+C) over sunitinib.
• Disparities in mortality rates among Black patients with metastatic clear cell RCC point to underlying racial disparities in outcomes, emphasizing the need for further research to understand and address these differences.
• The importance of real-world studies is underscored, offering valuable insights into the application of first-line treatments in diverse patient populations beyond the controlled clinical trial settings.
• Network meta-analyses provide comparative insights into the efficacy of various treatment regimens, although limitations exist due to potential confounding factors across different trials.

“[Long-term follow-up data from the CheckMate 214 and CheckMate 9ER trials] is reassuring and suggests that some patients are having long-term benefit from combination therapies — and not just a higher response rate at the initial time of treatment.”
– Wenxin “Vincent” Xu, MD; Harvard Medical Schools, Boston, Mass

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