A combination of two targeted therapy drugs can dramatically improve survival for certain patients with newly diagnosed advanced kidney cancer, data from a midstage trial suggests.
The trial testing the two drugs was launched before therapies known as immune-checkpoint inhibitors became the preferred treatment for such patients.
But checkpoint inhibitors such as Merck’s Keytruda and Bristol Myers Squibb’s Opdivo cannot be used by patients with autoimmune diseases, and their cost can be prohibitive, especially in low-resource settings.
The 51 patients in the trial — all with clear cell renal carcinoma that had spread throughout the body by the time it was first detected — received Votrient from Novartis (NOVN.S), opens new tab and Roche’s Avastin on an alternating basis.
Both drugs block the action of a protein called vascular endothelial growth factor, or VEGF, that promotes the growth of new blood vessels that can supply the tumor with oxygen and nutrients. Votrient’s effect on VEGF weakens over time, while Avastin actually removes VEGF from circulation.
The patients survived for a median of 63.2 months, including 24.8 months during which their disease did not worsen, researchers reported in The Lancet Oncology, opens new tab.
By comparison, when Votrient is given alone as the first-line treatment for patients with previously untreated metastatic clear cell renal cell carcinoma, overall survival ranges from 28.4 to 29.3 months, and median progression-free survival is just 9.2 months.
A particularly strong benefit was seen in the 33 trial participants who were considered “favorable-risk” based on their underlying health status. In this group, median progression-free survival, the time before the cancer began to worsen, reached 28.5 months and overall survival was 76.9 months, the researchers found.
In the favorable-risk patients, “the benefit from this novel regimen of (Votrient and Avastin) was comparable to or better than that of the contemporary immunotherapy combinations,” study leader Dr. Saby George of the Roswell
Park Comprehensive Cancer Center in Buffalo, New York, said in a statement. “This is significant due to the lower cost of this regimen compared to the immunotherapy combinations.”
