https://doi.org/10.55788/56513b66
The standard-of-care for patients with locoregional or oligometastatic RCC is radical nephrectomy with or without metastasectomy [1,2]. Adjuvant treatment with pembrolizumab significantly improved disease-free survival (DFS) compared with placebo after surgery among patients with RCC who were at high risk for recurrence [3]. The phase 3 IMmotion-010 trial (NCT03024996) evaluated the safety and efficacy of adjuvant therapy with atezolizumab for patients with RCC and increased risk of recurrence. Dr Axel Bex (The Royal Free London NHS Foundation Trust, UK) presented the results [4].
The IMmotion-010 trial enrolled 778 patients with resected intermediate to high-risk RCC (T2 Grade [Gr] 4, T3a Gr 3/4, T3b/c or T4 any Gr, TxN+ any Gr or M1 resected with no evidence of disease). Participants were 1:1 randomised to atezolizumab (1,200 mg every 3 weeks for 16 cycles or 1 year) or placebo. The primary endpoint was investigator-assessed DFS; key secondary endpoints were independent review facility-assessed DFS in the intention-to-treat (ITT) population and DFS in participants with PD-L1 immune cell expression ≥1%, overall survival (OS) and safety.
Adjuvant atezolizumab did not improve DFS versus placebo: median investigator-assessed DFS was 57.2 versus 49.5 months; 2-year investigator-assessed DFS was 67% versus 65% (HR 0.93; P=0.5). Exploratory analyses showed that atezolizumab improved DFS in patients (n=34) with PD-L1 immune cell expression of≥5%: HR 0.57) and in patients (n=104) with a sarcomatoid component (HR 0.77). Atezolizumab was well tolerated and the safety results were consistent with the known safety profile of atezolizumab.
“Atezolizumab as adjuvant therapy after resection for patients with RCC who have
increased risk of recurrence did not improve clinical outcomes compared with placebo. Further studies are needed to clarify the role of immunotherapy in the adjuvant setting for RCC,” summarised Dr Bex.
- Ingels A, et al. Nat Rev Urol. 2022;19(17):391–
- Ljunberg B, et al. Eur Urol. 2022;82(4):399–410.
- Choueiri TK, et al. N Engl J Med. 2021;385(8):683–694.
- Bex A, et al. IMmotion010: Efficacy and safety from the phase III study of atezolizumab (atezo) vs placebo (pbo) as adjuvant therapy in patients with renal cell carcinoma (RCC) at increased risk of recurrence after resection. Abstract LBA66, ESMO Congress 2022, 09–13 September, Paris, France.
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Table of Contents: ESMO 2022
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Letter from the Editor
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Deep learning models predict the risk of relapse and the mutational profile in GIST
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New, highly selective inhibitor of FGFR2 driver alterations and resistance mutations
Chemo-immunotherapy in gastric cancer is more effective when administered in parallel
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Tumour infiltrating lymphocytes identify patients with immunogenic triple-negative breast cancer
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OS benefit of sacituzumab govitecan in pre-treated HR-positive/HER2-negative metastatic breast cancer
Lung Cancer
A pathway from air pollution to lung cancer in non-smokers identified
Selective KRASG12C inhibitor sotorasib demonstrates superior PFS and ORR compared to docetaxel in previously treated patients with NSCLC
Promising clinical activity of tepotinib plus osimertinib in NSCLC with MET amplification after progression on first-line osimertinib
High pathological responses in borderline resectable NSCLC patients after induction with dual immunotherapy and concurrent chemoradiotherapy
Melanoma
Treatment with tumour-infiltrating lymphocytes for advanced melanoma outperforms ipilimumab
Neoadjuvant pembrolizumab outperforms adjuvant pembrolizumab in resectable stage III–IV melanomas
Survival-benefit of neoadjuvant T-VEC maintained over 5 years of follow-up
Baseline ctDNA predicts survival in resected stage III–IV melanoma
Genitourinary Cancer – Prostate Cancer
Overall survival benefit of abiraterone in mHSPC is maintained for 7 years
Limited benefit of adding long-term ADT to post-operative radiotherapy in prostate cancer
Intensified ADT benefits biochemical progression-free survival in biochemically relapsed prostate cancer
Genitourinary Cancer – Non-Prostate Cancer
Adjuvant nivolumab plus ipilimumab does not improve survival in patients with localised RCC at high risk of relapse after nephrectomy
Triple therapy improves progression-free survival in patients with advanced RCC versus dual therapy
Adjuvant atezolizumab does not improve outcomes for patients with RCC and increased risk of recurrence
Gynaecological cancers
OS benefit for advanced ovarian cancer patients treated with maintenance olaparib
Maintenance tegafur-uracil does not improve survival in locally advanced cervical cancer
Head and Neck Cancer
Adding first-line pembrolizumab to CRT in locally advanced HNSCC does not significantly prolong survival or event-free survival
5-FU-free chemotherapy combination as an alternative for first-line treatment of recurrent or metastatic HNSCC
Epstein Barr virus-specific autologous cytotoxic T lymphocytes do not improve survival in nasopharyngeal carcinoma
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