In a patient with intermediate risk metastatic RCC with high thrombotic tumor burden in the IVC extending to the right atrium, is there any clinical or biologic rationale to guide choice of therapy between axitinib/pembrolizumab vs nivolumab/ipilimumab?
Answer from: Medical Oncologist at Academic Institution
The short answer is no. IVC thrombi have never been reliably responsive to either IO or VEGF-targeted approaches. The first question may be if there is a role for debulking nephrectomy in this pt. If there is only 1 IMDC risk factor and this represents the majority of tumor burden, I still believe n...
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Answer from: Medical Oncologist at Academic Institution
In absence of direct side-by-side comparison between these regimens, either NIvo/ipi or pembro/axitinib is an option for intermediate risk metastatic RCC. Both these regimens showed better response rate and overall survival benefits vs. sunitinib in phase III trials. Nevertheless, I would avoi...
Answer from: Medical Oncologist at Community Practice
We have to compare CheckMate-214 with Keynote 426. There was a a higher objective response with a combination of PDL-1 targeting antibody and VEGFR targeting TKI combination. There was also lower reported grade 3 and 4 side effects. While superficially the Keynote 426 trial shows a superior alternat...