When do you consider using high dose IL-2 in patients with mRCC?

There were patients in the earlier Ipi/nivo phase 2 experience who were IL-2 failures and responded to Ipi/nivo, raising the hypothesis that the mechanism of response is not entirely overlapping. Thus, I believe HD IL-2 could still have a role even with modern combos, but will be used sparingly given toxicity issues. Favorable risk mRCC patients should receive axi/pembro based on level 1 evidence of OS benefit. It is inappropriate to look at the favorable risk subset (with a grand total of 17 ev...

The data for IL-2 has always been based on a carefully selected population - patients largely had lung only metastases, good performance status and other favorable features that truly skewed the data. Regimens such as nivolumab/ipilimumab and more recently axitinib/pembrolizumab certainly provide a higher level of evidence for front-line immunotherapy. I personally feel that the IL-2 candidates of yester-year are largely going to be "good-risk" by IMDC criteria - this is a population of patients...