MENUStudy finds immunotherapy, targeted therapy combination may be option for advanced kidney cancer
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Combination of pembrolizumab and bevacizumab proves safe and active for stage 4 kidney cancer, a multi-center trial run by the Big Ten Cancer Research Consortium finds
ANN ARBOR, Michigan -- A new study found that the combination of pembrolizumab and bevacizumab is safe and active in patients with metastatic kidney cancer. The trial, run by the Big Ten Cancer Research Consortium, was published online in the Journal of Clinical Oncology.
The multi-site phase Ib/II study looked at the combination of the immunotherapy drug pembrolizumab with bevacizumab for metastatic renal cell carcinoma. Pembrolizumab is known commercially as Keytruda and bevacizumab is known as Avastin.
The trial was designed to assess appropriate dosage of the drugs. The phase Ib portion enrolled 13 patients whose cancer had progressed on previous treatment. The phase II portion enrolled 48 patients who had not received any previous treatment. Overall, 61% of patients responded to the therapy. Previous studies have shown about 34% of patients respond to pembrolizumab alone and about 10% respond to bevacizumab alone.
“Current therapies for advanced kidney cancer carry serious and burdensome side-effects for a lot of patients including severe fatigue, severe hypertension, diarrhea and other GI side-effects. The side-effects in this trial, while not directly compared to alternate regimens, were tolerable and the treatment was highly effective,” says senior study author Ajjai Alva, M.D., M.S., a clinical researcher at the University of Michigan Rogel Cancer Center and associate professor of hematology/oncology at Michigan Medicine.
The study found the combination treatment kept the cancer from progressing for a median of 20.7 months. After 28 months of follow-up, the trial had not reached a median overall survival.
“It is sometimes also difficult for patients to remember to take oral pills every day and missed doses can impair effectiveness. These two drugs were given intravenously in this regimen, which may be a better way to ensure adherence. Further studies are needed to see if this combination could perhaps become a standard regimen for advanced kidney cancer,” Alva says.
The trial was led by Arkadiusz Z. Dudek, M.D., professor of hematology/oncology at the University of Illinois at Chicago, and medical oncologist at HealthPartners Regions Cancer Care Center in St. Paul, Minnesota.
“Our study demonstrated that pembrolizumab and bevacizumab can control metastatic kidney cancer for more than 20 months in the majority of patients treated,” Dudek says. “We think that pembrolizumab and bevacizumab could be an attractive alternative to the current standard combination of immune checkpoint inhibitor therapy and tyrosine kinase inhibitor. This will be especially important for patients who are elderly, have significant comorbidities, or do not tolerate front-line treatment using immune checkpoint inhibitors or tyrosine kinase inhibitors.”
The Big Ten Cancer Research Consortium was created in 2013 to transform the conduct of cancer research through collaborative, hypothesis-driven, highly translational oncology trials that leverage the scientific and clinical expertise of Big Ten universities. The goal of the Big Ten Cancer Research Consortium is to create a unique team-research culture to drive science rapidly from ideas to new approaches to cancer treatment. Within this innovative environment, today’s research leaders collaborate with and mentor the research leaders of tomorrow with the unified goal of improving the lives of all patients with cancer.
“Collaboration among Big Ten institutions was pivotal for the success of this study,” Dudek says. “Because of this collaboration, the study accrued patients in a shorter than anticipated period of time, and also provided high-quality clinical data, as well as blood and tissue for exploratory studies.”
Citation: Journal of Clinical Oncology, DOI: 10.1200/JCO.19.02394, published online Feb. 25, 2020