Advertisement


Toni K. Choueiri, MD, and Laurence Albiges, MD, PhD, on RCC: Review of Two Key Abstracts on Belzutifan Plus Cabozantinib and Pembrolizumab Plus Lenvatinib

ESMO Congress 2022

Advertisement

Toni K. Choueiri, MD, of the Dana-Farber Cancer Institute, and Laurence Albiges, MD, PhD, of France’s Gustave Roussy Cancer Centre, discuss results from two important trials presented at ESMO 2022: Cohort 1 of the LITESPARK-003 study of belzutifan plus cabozantinib as first-line treatment of advanced renal cell carcinoma (RCC), and the KEYNOTE-B61 study of pembrolizumab plus lenvatinib as first-line treatment for non–clear cell RCC (Abstracts 1447O and 1448O).



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
Toni K. Choueiri: Professor Albiges, really, it's great to be back in person at ESMO 2022 à Paris where you live and work and exciting data in kidney cancer. You have presented a part of an oral presentation, a session, results in unclear cell renal cell cancer in untreated unclear cell RCC. Tell us a bit about this first time presented study of pembrolizumab and lenvatinib. Laurence Albiges: Professor Choueiri, thank you for the highlight. Well first it's a pleasure to have everyone back in person here in Paris for this ESMO 2022. The B61 study is an important study. As you mentioned, this is the first time this data is being presented. It's a non-randomized phase II exploring the combination of lenvatinib plus pembrolizumab in patients with non-clear cell RCC. We do know it's an unmet need, we know those patient has worse prognosis and usually don't respond well to our classic VEGF TKI. What the study reports is a high response rate, 48% of overall response rate in the first 82 patients that have been enrolled in the study, more than 50% in patient with papillary RCC. We see the similar response rates with unclassified RCC or translocation RCC. However, limited benefit, unfortunately, with chromophobe RCC. What I want to stress is that there is clearly a good safety management in this study, meaning no new safety signal when compared to the prior report of lenvatinib plus pembrolizumab. The data are still maturing because we only have eight months follow up, so median PFS and OS are not yet reached. Toni K. Choueiri: That's great. Are you planning the next study, a randomized trial, where the experimental arm is pembrolizumab-lenvatinib? Laurence Albiges: It's a good question. I think the field should push forward having a trial within each subset of tumor. You are paving the way with the papillary MET inhibitor. I think we should push towards more specific trials in each subtype. Toni K. Choueiri: I agree. We have trials looking at the different combinations. Some of them are VEGF-directed, other are specifically MET-directed, whether selected or unselected. Another thing in renal cell cancer, this new target, HIF2, that we thought for a long time that this transcription factor was not going to be able to target until belzutifan came on. You're involved with some of the study as well? Laurence Albiges: Absolutely. Toni K. Choueiri: Yeah. Laurence Albiges: I think one of the questions is, where does this agent fit in our treatment landscape? And should it be considered as a single agent or a combination? You are reporting, at this ESMO, a combination study in first-line of cabozantinib plus belzutifan. Can you tell us more? Toni K. Choueiri: Yeah, no, I think it's an interesting combination, because actually it doesn't have, surprisingly, an immune checkpoint to blocker in first line. So there are some patients that had, significant number of patients with severe risk. Nevertheless, the safety profile of combining the VEGF-TKI cabozantinib AT full dose, 60 milligram once a day, with the HIF2 inhibitor belzutifan, in term of safety, it wasn't different from what we reported in patients previously treated. So, cabozantinib, we need to have significant dose reductions and belzutifan, less so. But very few patient discontinued study treatment because of toxicity. What we've seen, knowing the follow-up remains short, is a response rate of 57%. That's quite really compelling. We've seen a progression-free survival in this single-arm study, with all the limitations of single-arm studies, of 30 months, which it's an actuarial rather than an actual PFS, simply because the median follow up is shorter than the actual PFS. That's quite encouraging, and what I encourage most about is no patient had PD as best response. So I think that bodes well for the ongoing combination, one in the second line, not with cabozantinib, with lenvatinib, and belzutifan. Another one in the first line with also lenvatinib, belzutifan, but also the pembrolizumab. Until we wait, we're both involved in 005, which is single-agent belzutifan versus everolimus in heavily pretreated patients. So, really exciting ESMO 2022 and it's so good to be back in Paris and having the wonderful food.

Related Videos

Colorectal Cancer

Marinde J.G. Bond, PhD Candidate, on Colorectal Liver Metastases: FOLFOX/FOLFIRI, Bevacizumab, and Panitumumab

Marinde J.G. Bond, PhD Candidate, of the University Medical Center, Utrecht, discusses phase III findings from the CAIRO5 study of the Dutch Colorectal Cancer Group, the first such trial in defined subgroups of patients with initially unresectable colorectal cancer liver metastases and left-sided and RAS/BRAF V600E wild-type tumor. The study compared FOLFOX/FOLFIRI plus either bevacizumab or panitumumab (Abstract LBA21).

 

Lung Cancer

Charles Swanton, PhD, on Non–Small Cell Lung Cancer Induced by Air Pollution

Charles Swanton, PhD, of The Francis Crick Institute, discusses a newly discovered mechanism of action for air pollution–induced non–small cell lung cancer in which particles linked to climate change appear to promote cancerous changes. The finding might pave the way for new potential approaches to lung cancer prevention and treatment (Abstract LBA1).

Head and Neck Cancer
Immunotherapy

Jean-Pascal Machiels, MD, PhD, on Head and Neck Cancer: Recent Data on Pembrolizumab and Chemoradiation Therapy

Jean-Pascal Machiels, MD, PhD, of Belgium’s Cliniques universitaires Saint-Luc (UCLouvain), discusses the primary results of the phase III KEYNOTE-412 study of pembrolizumab plus chemoradiation therapy (CRT) vs placebo plus CRT for patients with locally advanced head and neck squamous cell carcinoma (Abstract LBA5).

Lung Cancer
Immunotherapy

Gérard Zalcman, MD, PhD, on Non–Small Cell Lung Cancer: Phase III Trial Findings on Nivolumab and Ipilimumab

Gérard Zalcman, MD, PhD, of France’s Bichat-Claude Bernard Hospital, Assistance Publique–Hôpitaux de Paris, discusses phase III results from the IFCT-1701 trial, which explored the questions of whether to administer nivolumab plus ipilimumab for 6 months or whether to prolong the treatment in patients with advanced non–small cell lung cancer (Abstract 972O).

Gynecologic Cancers

Paul A. DiSilvestro, MD, on Ovarian Cancer: New Data on Olaparib in Newly Diagnosed Disease

Paul A. DiSilvestro, MD, of Women & Infants Hospital and the Warren Alpert Medical School of Brown University, discusses overall survival results after a 7-year follow-up of the SOLO1/GOG-3004 trial for patients with newly diagnosed advanced ovarian cancer and a BRCA mutation who received maintenance olaparib. Dr. DiSilvestro details the increasing role of such PARP inhibitors in ovarian cancer treatment and their benefit to patients (Abstract 517O).

Advertisement

Advertisement



Advertisement