ESMO E-Learning: Next Generation Drugs in Kidney Cancer

Learning Objectives

  • To put into clinical perspective data from recent clinical trials with targeted therapies in patients with advanced renal cell cancer
  • To put into clinical perspective data from recent clinical trials with checkpoint inhibitors in patients with advanced renal cell cancer
  • To elaborate therapeutic approaches that are currently being examined in the clinical trial setting among renal cell cancer patients with potential to enter clinical practice in the future
Title Duration Content CME Points CME Test
Next Generation Drugs in Kidney Cancer 79 min. 90 slides 1 Take Test
Aine O’Reilly
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Until recently, systemic therapy for renal cell cancer (RCC) has been centred around the targeting of two key signalling pathways: the VEGF signalling pathway and the PI3K/Akt/mTOR pathway with a further small proportion of patients being suitable for treatment with Interleukin-2.

The last few years have been characterised by the introduction of new therapies to the therapeutic landscape that have demonstrated an overall survival advantage in randomised trials. The approval of these new agents has defined a new era in the treatment of metastatic RCC.

The author introduces the outline of this E-Learning module, commenting that likely this is only the beginning of an era defined by new and novel systemic therapies resulting in durable responses for increasing proportions of patients. In the first part of the module, the author elaborates agents that have recently demonstrated activity in randomised trials in metastatic RCC and have received regulatory approval. Cabozantinib and nivolumab have regulatory approval for the treatment of advanced RCC, of clear cell histology that has progressed on at least one line of VEGF targeted therapy. These approvals are based on the demonstration of an overall survival advantage in the phase III trials. The author emphasizes that the introduction of the immune checkpoint inhibitors has altered the profile of toxicity encountered in treating metastatic RCC. The combination of lenvatinib and everolimus has regulatory approval for the treatment of advanced RCC, of clear cell histology that has progressed on at least one line of VEGF targeted therapy. This approval is based on the results of a randomised phase II trial.

In part two, the author discusses therapies that are currently being examined in the clinical trial setting and have the potential to enter clinical practice in the future. The next generation of clinical trials in metastatic RCC are focused on combination therapy either combining dual immune checkpoint inhibitor or an immune checkpoint inhibitor with a targeted therapy. The superior approach in terms of efficacy and durability remains to be seen.

Last update: 25 May 2018

The author has reported no conflicts of interest.