Recent Advances In Treating Advanced Kidney Cancer

Thomas Hutson, DO, PharmD, FACP, Director of the Urologic Oncology Program at Baylor University Medical Center and the Sarah Cannon Research Institute at Texas Oncology I The US Oncology Networkdiscussed the advances made in treating kidney cancer, including his recent trial testing the efficacy of lenvatinib and pembrolizumab to treat advanced renal cell carcinoma.
Renal cell carcinoma is the most common type of kidney cancer accounting for about nine out of 10 diagnoses. Survival is largely dependent on the stage of the cancer. The five-year survival rate for those with metastatic renal cell carcinoma is approximately 15% and about 30% of patients initially diagnosed with this cancer will have a metastatic form.
As noted by Dr. Hutson, tremendous advances have been made in the past two decades to treat renal cell carcinoma. At ASCO 2023, Dr. Hudson presented data from a Phase 3 clinical trial testing lenvatinib and pembrolizumab versus sunitinib. After four years of follow-up, lenvatinib and pembrolizumab reduced the risk of death by 21% compared to sunitinib. Further, the 24- and 36-month estimated overall survival rates were 80.4% and 66.4% for lenvatinib and pembrolizumab compared to 69.6% and 60.2% for sunitinib, respectively.
Grade 3 or more treatment-related adverse events (TRAE) occurred in 74.1% of patients who received lenvatinib and pembrolizumab versus 60.3% of patients who received sunitinib. The most common TRAEs of any grade of patients given lenvatinib and pembrolizumab were diarrhea (56.0%), hypertension (54.3%), hypothyroidism (44.9%), decreased appetite (35.5%), fatigue (34.1%) and stomatitis (32.7%). In the sunitinib arm, the six most common TRAEs were diarrhea (45.3%), hypertension (40.3%), stomatitis (37.4%), palmar-plantar erythrodysesthesia (36.2%), fatigue (32.9%) and nausea (28.2%).