touchEXPERT BRIEFING

Managing the treatment of patients with advanced renal cell carcinoma

Access to this content is not permitted for healthcare professionals based in the UK

Back to Learning Zone

This content is intended for healthcare professionals in Europe (excluding UK) only.

Please confirm that you are a healthcare professional in Europe (excluding UK).

Decline

This activity has been initiated and funded by Eisai. Eisai provided financial support, has had input into the selection of the faculty and the detailed project scope, and has reviewed the material for compliance and technical accuracy. This activity is provided by Touch Medical Communications (TMC) for touchONCOLOGY.

Renal Cancer View Time: 22 mins

touchEXPERT BRIEFING Managing the treatment of patients with advanced renal cell carcinoma

Leading experts provide an overview of the development of advanced RCC, current treatments and how to manage common associated AEs.

Now Playing:
Up Next:
 
 
Pathological features of advanced RCC and treatment options

Professors Staehler and Grünwald discuss key pathological features of advanced RCC and the impact that TKI and ICI monotherapies have had on disease outcomes.

1/3 Next Interview
 
 
Standard of care treatment options and outcomes for advanced RCC

Professors Staehler and Grünwald outline the rationale for combining tyrosine kinase and immune checkpoint inhibitors in advanced RCC, and discuss their impact on patients.

2/3 Next Interview
 
 
Managing AEs in advanced RCC

Professors Staehler and Grünwald highlight the most common AEs experienced by patients treated with tyrosine kinase and immune checkpoint inhibitors and how to manage AEs.

3/3 Leave Feedback
Leave Feedback
Overview & Learning Objectives
Overview

Disease prognosis remains limited for patients with advanced renal cell carcinoma (RCC) despite the development of targeted agents.1, 2 Current standard of care treatment options include VEGF receptor tyrosine kinase inhibitors in combination with immune-checkpoint inhibitors (ICI), and ICI combinations.3, 4 Both classes of combination lead to improved disease outcomes over monotherapy.5–8 However, patients may experience common adverse events,9-14 which require careful management to ensure that patients can continue to receive treatment for as long as possible to maximise efficacy.15 In this touchEXPERT BRIEFING, leading experts provide an overview of the development of advanced RCC, disease outcomes with current standard of care treatment and how to manage common associated AEs.

Learning Objectives

After watching this activity, participants should be better able to:

  • Provide an overview of the development of advanced RCC, treatment options and disease outcomes.
  • Describe the standard of care treatment options for advanced RCC and associated disease outcomes.
  • Discuss common AEs with standard of care treatment and management strategies to facilitate good treatment outcomes.
About Faculty
Prof. Dr Michael Staehler

University Hospital of Munich, Munich, Germany

Michael Staehler received his medical qualification from the University of Munich, and a PhD from the Free University, Berlin. In addition to being Head of the Interdisciplinary Centre for Renal Tumors at the Ludwig-Maximilians University of Munich, he is also a member of the Renal Cancer Workgroup of the German Cancer Society, and German Guideline Committee on Renal Cancer. His main research interests are in the development of novel therapeutics in renal cell carcinoma and he has published over 200 articles on renal cancer.

Disclosures

Prof. Dr Michael Staehler discloses: Honoraria from: Pfizer, Novartis, Roche, Ipsen, Bristol Myers Squibb, Exelixis, Bayer, EUSA Pharma, Incyte, Astellas Pharma, MSD Oncology, EMD Serono. Consulting or Advisory Role from: Pfizer, Novartis, Ipsen, Exelixis, Eisai, Bristol Myers Squibb, EUSA Pharma, Merck Sharp & Dohme, EMD Serono. Speakers’ Bureau from: Pfizer, Novartis, Bristol Myers Squibb, Eisai, Ipsen, EUSA Pharma. Research Funding: Pfizer (Inst), Genentech (Inst), Exelixis (Inst), Novartis, Bayer (Inst), Bristol Myers Squibb (Inst). Travel, Accommodations, Expenses from: Pfizer, Novartis, Bristol Myers Squibb, Eisai, Ipsen, EUSA Pharma, MSD Oncology, EMD Serono.

Prof. Dr Viktor Grünwald

University Hospital Essen, Essen, Germany

Viktor Grünwald received his medical degree from the Medical School Hannover. He has served on the steering and scientific committees for oncology congresses including ESMO, ESMO ASIA, DKK and DGHO, in addition to chairing several different working groups in academic organisations. His main research interests are in genitourinary cancers, soft tissue sarcomas, and head and neck cancers, with an emphasis on using immunotherapies in their treatment.

Disclosures

Prof. Dr Viktor Grünwald discloses: Stock and Other Ownership Interests from: AstraZeneca; Bristol-Myers Squibb; MSD. Honoraria from: Asklepios Kliniken; AstraZeneca; Bayer; Bristol-Myers Squibb; Clinic of Oldenburg; Diakonie Clinic; Dortmund Hospital; Eisai; EUSA Pharma; Ipsen; Janssen-Cilag; Lilly; Merck Serono; MSD Oncology; Novartis; Pfizer; PharmaMar; Roche. Consulting or Advisory Role from: Bristol-Myers Squibb; Cor2Ed; Ipsen; Janssen-Cilag; Lilly; MSD Oncology; Novartis; Onkowissen; Pfizer. Research Funding from: Novartis (Inst). Travel, Accommodations, Expenses from: AstraZeneca; Bayer; Bristol-Myers Squibb; Ipsen; Pfizer

References
  1. Tannir NM, Pal SK, Atkins MB. Second-Line Treatment Landscape for Renal Cell Carcinoma: A Comprehensive Review. Oncologist. 2018;23(5):540-555.
  2. Coppin C, Porzsolt F, Awa A, et al. Immunotherapy for advanced renal cell cancer. Cochrane Database Syst Rev. 2005;(1):CD001425.
  3. Ljungberg B, Albiges L, Abu-Ghanem Y, et al. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2022 Update. Eur Urol. 2022:S0302-2838(22)01676-1.
  4. Powles T, Albiges L, Bex A, et al. ESMO Clinical Practice Guideline update on the use of immunotherapy in early stage and advanced renal cell carcinoma. Ann Oncol. 2021;32(12):1511-1519
  5. Powles T, et al. Pembrolizumab plus axitinib versus sunitinib monotherapy as first-line treatment of advanced renal cell carcinoma (KEYNOTE-426): extended follow-up from a randomised, open-label, phase 3 trial. Lancet Oncol. 2020;21(12):1563-1573.
  6. Choueiri TK, Powles T, Burotto M, et al. Nivolumab plus Cabozantinib versus Sunitinib for Advanced Renal-Cell Carcinoma. N Engl J Med. 2021;384(9):829-841.
  7. Motzer R, Alekseev B, Rha SY, et al. Lenvatinib plus Pembrolizumab or Everolimus for Advanced Renal Cell Carcinoma. N Engl J Med. 2021;384(14):1289-1300.
  8. Albiges L, Tannir NM, Burotto M, et al. Nivolumab plus ipilimumab versus sunitinib for first-line treatment of advanced renal cell carcinoma: extended 4-year follow-up of the phase III CheckMate 214 trial. ESMO Open. 2020;5(6):e001079.
  9. EMA. Inlyta (axitinib) tablets. Available at: https://www.ema.europa.eu/en/documents/product-information/inlyta-epar-product-information_en.pdf (accessed December 2022).
  10. EMA. Cabometyx (cabozantinib) tablets. Available at: https://www.ema.europa.eu/en/documents/product-information/cabometyx-epar-product-information_en.pdf (accessed December 2022).
  11. 11. EMA. Lenvima (lenvatnib) capsules. Available at: https://www.ema.europa.eu/en/documents/product-information/lenvima-epar-product-information_en.pdf (accessed December 2022).
  12. Choueiri TK, Escudier B, Powles T, et al. Cabozantinib versus everolimus in advanced renal cell carcinoma (METEOR): final results from a randomised, open-label, phase 3 trial. Lancet Oncol. 2016;17(7):917-927.
  13. Motzer RJ, Tannir NM, McDermott DF, et al. Nivolumab plus Ipilimumab versus Sunitinib in Advanced Renal-Cell Carcinoma. N Engl J Med. 2018;378(14):1277-1290.
  14. Spain L, Diem S, Larkin J. Management of toxicities of immune checkpoint inhibitors. Cancer Treat Rev. 2016;44:51-60.
  15. Eisen T, Sternberg CN, Robert C, Mulders P, Pyle L, Zbinden S, et al. Targeted therapies for renal cell carcinoma: review of adverse event management strategies. J Natl Cancer Inst. 2012;104(2):93-113.
  16. American Cancer Society. What Is Kidney Cancer. Available at: https://www.cancer.org/cancer/kidney-cancer/about/what-is-kidney-cancer.html (December 2022)
  17. Cancer Genome Atlas Research Network. Comprehensive molecular characterization of clear cell renal cell carcinoma. Nature. 2013;499(7456):43-9.
  18. Cella D, Grünwald V, Escudier B, et al. Patient-reported outcomes of patients with advanced renal cell carcinoma treated with nivolumab plus ipilimumab versus sunitinib (CheckMate 214): a randomised, phase 3 trial. Lancet Oncol. 2019;20(2):297-310.
  19. Cella D, Motzer RJ, Suarez C, et al. Patient-reported outcomes with first-line nivolumab plus cabozantinib versus sunitinib in patients with advanced renal cell carcinoma treated in CheckMate 9ER: an open-label, randomised, phase 3 trial. Lancet Oncol. 2022;23(2):292-303;
  20. Choueiri TK, Kaelin WG Jr. Targeting the HIF2-VEGF axis in renal cell carcinoma. Nat Med. 2020;26(10):1519-1530.
  21. Curran MA, Montalvo W, Yagita H, et al. PD-1 and CTLA-4 combination blockade expands infiltrating T cells and reduces regulatory T and myeloid cells within B16 melanoma tumors. Proc Natl Acad Sci U S A. 2010;107(9):4275-80
  22. Díaz-Montero CM, Rini BI, Finke JH. The immunology of renal cell carcinoma. Nat Rev Nephrol. 2020;16(12):721-735.
  23. McDermott DF, Lee JL, Bjarnason GA, et al. Open-Label, Single-Arm Phase II Study of Pembrolizumab Monotherapy as First-Line Therapy in Patients With Advanced Clear Cell Renal Cell Carcinoma. J Clin Oncol. 202;39(9):1020-1028.
  24. McGregor B, Mortazavi A, Cordes L, et al. Management of adverse events associated with cabozantinib plus nivolumab in renal cell carcinoma: A review. Cancer Treat Rev. 2022;103:102333.
  25. Motzer RJ, Escudier B, George S, et al. Nivolumab versus everolimus in patients with advanced renal cell carcinoma: Updated results with long-term follow-up of the randomized, open-label, phase 3 CheckMate 025 trial. Cancer. 2020;126(18):4156-4167.
  26. Motzer RJ, Hutson TE, Cella D, et al. Pazopanib versus sunitinib in metastatic renal-cell carcinoma. N Engl J Med. 2013;369(8):722-31.
  27. Motzer R, Porta C, Alekseev B, et al. Health-related quality-of-life outcomes in patients with advanced renal cell carcinoma treated with lenvatinib plus pembrolizumab or everolimus versus sunitinib (CLEAR): a randomised, phase 3 study. Lancet Oncol. 2022:S1470-2045(22)00212-1.
  28. Powles T, et al. Pembrolizumab plus axitinib versus sunitinib monotherapy as first-line treatment of advanced renal cell carcinoma (KEYNOTE-426): extended follow-up from a randomised, open-label, phase 3 trial. Lancet Oncol. 2020;21(12):1563-1573.
  29. Ravaud A. Treatment-associated adverse event management in the advanced renal cell carcinoma patient treated with targeted therapies. Oncologist. 2011;16(Suppl 2):32-44.
  30. Rini BI, Plimack ER, Stus V, et al. Pembrolizumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma. N Engl J Med. 2019;380(12):1116-1127.
  31. Schmidinger M, Bergler-Klein J. Therapy management of cardiovascular adverse events in the context of targeted therapy for metastatic renal cell carcinoma. Int J Urol. 2012;19(9):796-804.
Downloads

View and download resources from this activity to support your learning and share with colleagues

Feedback Close
Feedback

Please provide feedback for this touchEXPERT BRIEFING on the following
(scale of 1-5 where 1=strongly disagree and 5=strongly agree):

* = Mandatory Field

Feedback Close
Copied to clipboard!
accredited arrow-down-editablearrow-downarrow_leftarrow-right-bluearrow-right-dark-bluearrow-right-greenarrow-right-greyarrow-right-orangearrow-right-whitearrow-right-bluearrow-up-orangeavatarcalendarchevron-down consultant-pathologist-nurseconsultant-pathologistcrosscrossdownloademailexclaimationfeedbackfiltergraph-arrowinterviewslinkmdt_iconmenumore_dots nurse-consultantpadlock patient-advocate-pathologistpatient-consultantpatientperson pharmacist-nurseplay_buttonplay-colour-tmcplay-colourAsset 1podcastprinter scenerysearch share single-doctor social_facebooksocial_googleplussocial_instagramsocial_linkedin_altsocial_linkedin_altsocial_pinterestlogo-twitter-glyph-32social_youtubeshape-star (1)tick-bluetick-orangetick-red tick-whiteticktimetranscriptup-arrowwebinar Sponsored Department Location NEW TMM Corporate Services Icons-07NEW TMM Corporate Services Icons-08NEW TMM Corporate Services Icons-09NEW TMM Corporate Services Icons-10NEW TMM Corporate Services Icons-11NEW TMM Corporate Services Icons-12Salary £ TMM-Corp-Site-Icons-01TMM-Corp-Site-Icons-02TMM-Corp-Site-Icons-03TMM-Corp-Site-Icons-04TMM-Corp-Site-Icons-05TMM-Corp-Site-Icons-06TMM-Corp-Site-Icons-07TMM-Corp-Site-Icons-08TMM-Corp-Site-Icons-09TMM-Corp-Site-Icons-10TMM-Corp-Site-Icons-11TMM-Corp-Site-Icons-12TMM-Corp-Site-Icons-13TMM-Corp-Site-Icons-14TMM-Corp-Site-Icons-15TMM-Corp-Site-Icons-16TMM-Corp-Site-Icons-17TMM-Corp-Site-Icons-18TMM-Corp-Site-Icons-19TMM-Corp-Site-Icons-20TMM-Corp-Site-Icons-21TMM-Corp-Site-Icons-22TMM-Corp-Site-Icons-23TMM-Corp-Site-Icons-24TMM-Corp-Site-Icons-25TMM-Corp-Site-Icons-26TMM-Corp-Site-Icons-27TMM-Corp-Site-Icons-28TMM-Corp-Site-Icons-29TMM-Corp-Site-Icons-30TMM-Corp-Site-Icons-31TMM-Corp-Site-Icons-32TMM-Corp-Site-Icons-33TMM-Corp-Site-Icons-34TMM-Corp-Site-Icons-35TMM-Corp-Site-Icons-36TMM-Corp-Site-Icons-37TMM-Corp-Site-Icons-38TMM-Corp-Site-Icons-39TMM-Corp-Site-Icons-40TMM-Corp-Site-Icons-41TMM-Corp-Site-Icons-42TMM-Corp-Site-Icons-43TMM-Corp-Site-Icons-44TMM-Corp-Site-Icons-45TMM-Corp-Site-Icons-46TMM-Corp-Site-Icons-47TMM-Corp-Site-Icons-48TMM-Corp-Site-Icons-49TMM-Corp-Site-Icons-50TMM-Corp-Site-Icons-51TMM-Corp-Site-Icons-52TMM-Corp-Site-Icons-53TMM-Corp-Site-Icons-54TMM-Corp-Site-Icons-55TMM-Corp-Site-Icons-56TMM-Corp-Site-Icons-57TMM-Corp-Site-Icons-58TMM-Corp-Site-Icons-59TMM-Corp-Site-Icons-60TMM-Corp-Site-Icons-61TMM-Corp-Site-Icons-62TMM-Corp-Site-Icons-63TMM-Corp-Site-Icons-64TMM-Corp-Site-Icons-65TMM-Corp-Site-Icons-66TMM-Corp-Site-Icons-67TMM-Corp-Site-Icons-68TMM-Corp-Site-Icons-69TMM-Corp-Site-Icons-70TMM-Corp-Site-Icons-71TMM-Corp-Site-Icons-72