make you less likely to use this regimen?
Dr Powles: I think we have to look into questions with
underlying immune diseases. Those patients were excluded
from the trial. Overall, patients on immune suppressive
drugs or patients with active infections—those
patients were excluded from the trial. But the majority
of patients appeared to have a relatively good rating.
Dr Figlin: Has the Keynote-426 trial changed your paradigm
or approach?
84 Kidney Cancer Journal
Dr Powles: We’ve seen a change in European guidelines,
the European Association of Urology guidelines, and the
NCCN (National Comprehensive Cancer Network) American
guidelines. But that changed very rapidly off the
back of this trial. This is the best survival signal we’ve
ever seen in a randomized perspective. And it’s the first
time we’ve seen a survival signal for a VEGF-targeted therapy
combined with an immune therapy. So there are
many firsts with this trial, which is why it is so important.
Axitinib and pembrolizumab should be considered
as a standard of care for unselected patients and it appears
to maximize survival outcomes, which is really exciting.
KCJ
• Kidney Cancer Highlights from Two Scientific
Symposia: the European Society for Medical
Oncology (ESMO), Barcelona, Spain, September 27-
October 1, 2019 and the International Kidney
Cancer Symposium, Miami, Florida, November 15-
16, 2019
• The Role of Precision Medicine and Next
Generation Sequencing in ccRCC
• Survival Outcome of Pazopanib and Sunitinib
as First-line Targeted Therapy in Metastatic RCC –
a Retrospective Review from England
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