Compound drug therapy can be used to treat advanced kidney cancer
February 18, 2019 Source: Bio Valley
Window._bd_share_config={ "common":{ "bdSnsKey":{ },"bdText":"","bdMini":"2","bdMiniList":false,"bdPic":"","bdStyle":" 0","bdSize":"16"},"share":{ }};with(document)0[(getElementsByTagName('head')[0]||body).appendChild(createElement('script')) .src='http://bdimg.share.baidu.com/static/api/js/share.js?v=89860593.js?cdnversion='+~(-new Date()/36e5)];A recent study by the Dana-Farber Cancer Institute suggests that a dual-drug combination therapy may be the new standard first-line treatment for patients with metastatic renal cancer.
Patients receiving the immunotherapeutic drug avelumab plus axitinib (a targeted drug) had a significant advantage in progression-free survival compared with patients receiving sunitinib (Sutent). Among them, sunitinib is a standard drug for the treatment of advanced clear cell renal cell carcinoma.
“Patients who received this combination of drugs had a higher response rate (tumor reduction) than patients who received only sunitinib,†said Dr. Toni K. Choueiri, MD, senior and co-author of the study. The results were published in the recent New England Journal of Medicine. However, although combination therapy can improve progression-free survival, further follow-up is needed to show whether dual-agent therapy can extend overall survival compared to standard treatment regimens.
This trial is the first key study to combine avelumab with drugs that target vascular endothelial growth factor receptor (VEGFR). VEGFR blockers like sunitinib and axitinib are designed to starve tumors by destroying the blood supply. Immunotherapeutic drugs such as avelumab (blocking an immune checkpoint called PD-L1) act by activating "depleted" immune T cells, thereby attacking cancer cells more effectively.
The clinical trial involved 886 patients with previously untreated advanced renal cell carcinoma who were randomized to a combination therapy or to sunitinib alone.
The results of the study showed that median progression-free survival (PFS) - the length of time before cancer began to worsen - was 13.8 months in the combination group and 7.2 months in patients receiving only sunitinib. These results are particularly applicable to patients whose cancer cells are detected as positive for PD-L1 checkpoints blocked by avelumab. Among PD-L1-positive patients, the proportion of patients with tumor shrinkage treated with avelumab plus axitinib was 55.2%, and the proportion of patients treated with sunitinib alone was 25.5%.
Almost all patients in both treatment groups had some side effects. In the combination treatment group, 103.2% of patients had immune-related adverse events, the most common being thyroid disease, which was observed in 107 patients.
Information source: Drug combination may become new standard treatment for advanced kidney cancer
Original source: Robert J. Motzer et al. Avelumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma. New England Journal of Medicine, 2019; DOI: 10.1056/NEJMoa1816047
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