The 2021 Updated European Association of Urology Guidelines on Renal Cell Carcinoma: Immune Checkpoint Inhibitor–based Combination Therapies for Treatment-naive Metastatic Clear-cell Renal Cell Carcinoma Are Standard of Care

Jens Bedke; Laurence Albiges; Umberto Capitanio; Rachel H. Giles; Milan Hora; Thomas B. Lam; Börje Ljungberg; Lorenzo Marconi; Tobias Klatte; Alessandro Volpe; Yasmin Abu-Ghanem; Saeed Dabestani; Sergio Fernández Pello; Fabian Hofmann; Teele Kuusk; Rana Tahbaz; Thomas Powles; Axel Bex

doi:10.1016/j.eururo.2021.04.042

The 2021 Updated European Association of Urology Guidelines on Renal Cell Carcinoma: Immune Checkpoint Inhibitor–based Combination Therapies for Treatment-naive Metastatic Clear-cell Renal Cell Carcinoma Are Standard of Care

Jens Bedke
, Laurence Albiges
, Umberto Capitanio
, Rachel H. Giles
, Milan Hora
, Thomas B. Lam
, Börje Ljungberg
, Lorenzo Marconi
, Tobias Klatte
, Alessandro Volpe
, Yasmin Abu-Ghanem
, Saeed Dabestani
, Sergio Fernández Pello
, Fabian Hofmann
, Teele Kuusk
, Rana Tahbaz
, Thomas Powles
, Axel Bex

Department of Translational Medicine

Research output: Contribution to journal › Editorial

Abstract

The recent randomized controlled phase III CLEAR trial results are the last to complement immune checkpoint inhibitor (ICI)-based doublet combination therapies for treatment-naïve metastatic clear-cell renal cell carcinoma. The CLEAR trial demonstrated an improved progression-free survival (PFS), overall survival (OS), and an objective response rate (ORR) benefit for the combination of lenvatinib plus pembrolizumab over sunitinib. The CheckMate-9ER trial update demonstrated an ongoing PFS, OS, and quality-of-life benefit for cabozantinib plus nivolumab over sunitinib as did the update of Keynote-426 for axitinib plus pembrolizumab in the intention-to-treat population, with a PFS benefit seen across all International Metastatic Database Consortium (IMDC) subgroups. In the IMDC intermediate- and poor-risk groups, the CheckMate-214 trial of ipilimumab plus nivolumab confirmed the OS benefit with a PFS plateauing after 30 months. The RCC Guidelines Panel recommends three tyrosine kinase inhibitors + ICI combinations of axitinib plus pembrolizumab, cabozantinib plus nivolumab, and lenvatinib plus pembrolizumab across all IMDC risk groups in advanced first-line RCC, and dual immunotherapy of ipilimumab and nivolumab in IMDC intermediate- and poor-risk groups. Patient summary: New data from combination trials with immune checkpoint inhibitors for advanced kidney cancer confirm a survival benefit for lenvatinib plus pembrolizumab, cabozantinib plus nivolumab (with improved quality-of-life), axitinib plus pembrolizumab, and ipilimumab plus nivolumab. These combination therapies are recommended as first-line treatment for advanced kidney cancer.

Original language	English
Pages (from-to)	393-397
Number of pages	5
Journal	European Urology
Volume	80
Issue number	4
DOIs	https://doi.org/10.1016/j.eururo.2021.04.042
Publication status	Published - Oct 2021

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Cabozantinib
Clear-cell
First-line
Lenvatinib, pembrolzumab, nivolumab
Renal cell carcinoma
Systemic therapy
Treatment-naive

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Bedke, J., Albiges, L., Capitanio, U., Giles, R. H., Hora, M., Lam, T. B., Ljungberg, B., Marconi, L., Klatte, T., Volpe, A., Abu-Ghanem, Y., Dabestani, S., Pello, S. F., Hofmann, F., Kuusk, T., Tahbaz, R., Powles, T., & Bex, A. (2021). The 2021 Updated European Association of Urology Guidelines on Renal Cell Carcinoma: Immune Checkpoint Inhibitor–based Combination Therapies for Treatment-naive Metastatic Clear-cell Renal Cell Carcinoma Are Standard of Care. European Urology, 80(4), 393-397. https://doi.org/10.1016/j.eururo.2021.04.042

@article{9f7c679d78924f13b3c8ef82fb0c4743,

title = "The 2021 Updated European Association of Urology Guidelines on Renal Cell Carcinoma: Immune Checkpoint Inhibitor{\textendash}based Combination Therapies for Treatment-naive Metastatic Clear-cell Renal Cell Carcinoma Are Standard of Care",

abstract = "The recent randomized controlled phase III CLEAR trial results are the last to complement immune checkpoint inhibitor (ICI)-based doublet combination therapies for treatment-na{\"i}ve metastatic clear-cell renal cell carcinoma. The CLEAR trial demonstrated an improved progression-free survival (PFS), overall survival (OS), and an objective response rate (ORR) benefit for the combination of lenvatinib plus pembrolizumab over sunitinib. The CheckMate-9ER trial update demonstrated an ongoing PFS, OS, and quality-of-life benefit for cabozantinib plus nivolumab over sunitinib as did the update of Keynote-426 for axitinib plus pembrolizumab in the intention-to-treat population, with a PFS benefit seen across all International Metastatic Database Consortium (IMDC) subgroups. In the IMDC intermediate- and poor-risk groups, the CheckMate-214 trial of ipilimumab plus nivolumab confirmed the OS benefit with a PFS plateauing after 30 months. The RCC Guidelines Panel recommends three tyrosine kinase inhibitors + ICI combinations of axitinib plus pembrolizumab, cabozantinib plus nivolumab, and lenvatinib plus pembrolizumab across all IMDC risk groups in advanced first-line RCC, and dual immunotherapy of ipilimumab and nivolumab in IMDC intermediate- and poor-risk groups. Patient summary: New data from combination trials with immune checkpoint inhibitors for advanced kidney cancer confirm a survival benefit for lenvatinib plus pembrolizumab, cabozantinib plus nivolumab (with improved quality-of-life), axitinib plus pembrolizumab, and ipilimumab plus nivolumab. These combination therapies are recommended as first-line treatment for advanced kidney cancer.",

keywords = "Cabozantinib, Clear-cell, First-line, Lenvatinib, pembrolzumab, nivolumab, Renal cell carcinoma, Systemic therapy, Treatment-naive",

author = "Jens Bedke and Laurence Albiges and Umberto Capitanio and Giles, \{Rachel H.\} and Milan Hora and Lam, \{Thomas B.\} and B{\"o}rje Ljungberg and Lorenzo Marconi and Tobias Klatte and Alessandro Volpe and Yasmin Abu-Ghanem and Saeed Dabestani and Pello, \{Sergio Fern{\'a}ndez\} and Fabian Hofmann and Teele Kuusk and Rana Tahbaz and Thomas Powles and Axel Bex",

note = "Publisher Copyright: {\textcopyright} 2021 European Association of Urology",

year = "2021",

month = oct,

doi = "10.1016/j.eururo.2021.04.042",

language = "English",

volume = "80",

pages = "393--397",

journal = "European Urology",

issn = "0302-2838",

number = "4",

}

Bedke, J, Albiges, L, Capitanio, U, Giles, RH, Hora, M, Lam, TB, Ljungberg, B, Marconi, L, Klatte, T, Volpe, A, Abu-Ghanem, Y, Dabestani, S, Pello, SF, Hofmann, F, Kuusk, T, Tahbaz, R, Powles, T & Bex, A 2021, 'The 2021 Updated European Association of Urology Guidelines on Renal Cell Carcinoma: Immune Checkpoint Inhibitor–based Combination Therapies for Treatment-naive Metastatic Clear-cell Renal Cell Carcinoma Are Standard of Care', European Urology, vol. 80, no. 4, pp. 393-397. https://doi.org/10.1016/j.eururo.2021.04.042

The 2021 Updated European Association of Urology Guidelines on Renal Cell Carcinoma: Immune Checkpoint Inhibitor–based Combination Therapies for Treatment-naive Metastatic Clear-cell Renal Cell Carcinoma Are Standard of Care. / Bedke, Jens; Albiges, Laurence; Capitanio, Umberto et al.
In: European Urology, Vol. 80, No. 4, 10.2021, p. 393-397.

Research output: Contribution to journal › Editorial

TY - JOUR

T1 - The 2021 Updated European Association of Urology Guidelines on Renal Cell Carcinoma

T2 - Immune Checkpoint Inhibitor–based Combination Therapies for Treatment-naive Metastatic Clear-cell Renal Cell Carcinoma Are Standard of Care

AU - Bedke, Jens

AU - Albiges, Laurence

AU - Capitanio, Umberto

AU - Giles, Rachel H.

AU - Hora, Milan

AU - Lam, Thomas B.

AU - Ljungberg, Börje

AU - Marconi, Lorenzo

AU - Klatte, Tobias

AU - Volpe, Alessandro

AU - Abu-Ghanem, Yasmin

AU - Dabestani, Saeed

AU - Pello, Sergio Fernández

AU - Hofmann, Fabian

AU - Kuusk, Teele

AU - Tahbaz, Rana

AU - Powles, Thomas

AU - Bex, Axel

PY - 2021/10

Y1 - 2021/10

N2 - The recent randomized controlled phase III CLEAR trial results are the last to complement immune checkpoint inhibitor (ICI)-based doublet combination therapies for treatment-naïve metastatic clear-cell renal cell carcinoma. The CLEAR trial demonstrated an improved progression-free survival (PFS), overall survival (OS), and an objective response rate (ORR) benefit for the combination of lenvatinib plus pembrolizumab over sunitinib. The CheckMate-9ER trial update demonstrated an ongoing PFS, OS, and quality-of-life benefit for cabozantinib plus nivolumab over sunitinib as did the update of Keynote-426 for axitinib plus pembrolizumab in the intention-to-treat population, with a PFS benefit seen across all International Metastatic Database Consortium (IMDC) subgroups. In the IMDC intermediate- and poor-risk groups, the CheckMate-214 trial of ipilimumab plus nivolumab confirmed the OS benefit with a PFS plateauing after 30 months. The RCC Guidelines Panel recommends three tyrosine kinase inhibitors + ICI combinations of axitinib plus pembrolizumab, cabozantinib plus nivolumab, and lenvatinib plus pembrolizumab across all IMDC risk groups in advanced first-line RCC, and dual immunotherapy of ipilimumab and nivolumab in IMDC intermediate- and poor-risk groups. Patient summary: New data from combination trials with immune checkpoint inhibitors for advanced kidney cancer confirm a survival benefit for lenvatinib plus pembrolizumab, cabozantinib plus nivolumab (with improved quality-of-life), axitinib plus pembrolizumab, and ipilimumab plus nivolumab. These combination therapies are recommended as first-line treatment for advanced kidney cancer.

AB - The recent randomized controlled phase III CLEAR trial results are the last to complement immune checkpoint inhibitor (ICI)-based doublet combination therapies for treatment-naïve metastatic clear-cell renal cell carcinoma. The CLEAR trial demonstrated an improved progression-free survival (PFS), overall survival (OS), and an objective response rate (ORR) benefit for the combination of lenvatinib plus pembrolizumab over sunitinib. The CheckMate-9ER trial update demonstrated an ongoing PFS, OS, and quality-of-life benefit for cabozantinib plus nivolumab over sunitinib as did the update of Keynote-426 for axitinib plus pembrolizumab in the intention-to-treat population, with a PFS benefit seen across all International Metastatic Database Consortium (IMDC) subgroups. In the IMDC intermediate- and poor-risk groups, the CheckMate-214 trial of ipilimumab plus nivolumab confirmed the OS benefit with a PFS plateauing after 30 months. The RCC Guidelines Panel recommends three tyrosine kinase inhibitors + ICI combinations of axitinib plus pembrolizumab, cabozantinib plus nivolumab, and lenvatinib plus pembrolizumab across all IMDC risk groups in advanced first-line RCC, and dual immunotherapy of ipilimumab and nivolumab in IMDC intermediate- and poor-risk groups. Patient summary: New data from combination trials with immune checkpoint inhibitors for advanced kidney cancer confirm a survival benefit for lenvatinib plus pembrolizumab, cabozantinib plus nivolumab (with improved quality-of-life), axitinib plus pembrolizumab, and ipilimumab plus nivolumab. These combination therapies are recommended as first-line treatment for advanced kidney cancer.

KW - Cabozantinib

KW - Clear-cell

KW - First-line

KW - Lenvatinib, pembrolzumab, nivolumab

KW - Renal cell carcinoma

KW - Systemic therapy

KW - Treatment-naive

UR - https://www.scopus.com/pages/publications/85107068841

U2 - 10.1016/j.eururo.2021.04.042

DO - 10.1016/j.eururo.2021.04.042

M3 - Editorial

SN - 0302-2838

VL - 80

SP - 393

EP - 397

JO - European Urology

JF - European Urology

IS - 4

ER -

The 2021 Updated European Association of Urology Guidelines on Renal Cell Carcinoma: Immune Checkpoint Inhibitor–based Combination Therapies for Treatment-naive Metastatic Clear-cell Renal Cell Carcinoma Are Standard of Care

Abstract

UN SDGs

Keywords

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