ASCO20 Highlights
Unpacking the Virtual ASCO20 Sessions: What Are The
Latest Developments in the RCC Toolbox?
Senthil Pazhanisamy, PhD
Executive editor, Kidney Cancer Journal
espite the unprecedented virtual nature of its program,
this year’s American Society of Clinical Oncology
(ASCO) fulfilled its promise of offering a
D
“diverse program, a multidisciplinary perspective, and a
wealth of new research, and limitless opportunities for
discovery” as thousands of oncologists around the world
gather virtually to learn about the latest research in cancer.
In ASCO20 meeting alone, the impactful results from
several major trials have once again changed the landscape
of front-line treatment that may provide a paradigm
shift in how renal cancers are managed and/or
treated in the future.
A review of highlights from the sessions suggests how
latest breakthrough results could:
• Open up an avenue of a new class therapy: HIF-2
inhibitor MK-6428 owing to its promising efficacy
and tolerability in patients with advanced RCC.
• Further clarify multiple choices in frontline ther
apy, including the immune checkpoint inhibitor
(ICI) therapy alone or combination with tyrosine
kinase inhibitor (TKI).
• Address whether it is appropriate to sequence PD-1
inhibitor vs using them in combination.
• Help us assess the association of gene expression
signatures and DNA alterations with response or
resistance to immunotherapy.
• Provide important clues about angiogenic and
myeloid expression markers to stratify patients
based on transcriptomic profile as well as its prog
nostic significance.
The abstracts included in this report have been selected
by Robert A. Figlin, MD, Editor-in-Chief of the Kidney
Cancer Journal and appear in an abbreviated format due
to space constraints. These chosen abstracts highlight
the most important trends in ongoing clinical studies
and also reflect the breakthrough research from latest trials
that impact the current standard of care in renal cancer.
The full abstracts can be viewed on our KCJ website,
please check out: https://kidney-cancer-journal.com/
asco.html.
n Abstract 5001: Pembrolizumab plus axitinib
versus sunitinib as first-line therapy for advanced
renal cell carcinoma (RCC): Updated analysis of
KEYNOTE-426. Elizabeth R. Plimack, Brian I. Rini,
Viktor Stus et al.
Results: 861 pts were randomly assigned (pembro + axi,
n = 432; sunitinib, n = 429). Median (range) duration of
follow-up for all pts was 27.0 mo (0.1-38.4). Pembro +
axi improved OS (HR, 0.68 95% CI, 0.55-0.85; P< 0.001;
24-mo OS rate, 74% vs 66%) vs sunitinib. Median (95%
CI) OS was not reached with pembro + axi and was 35.7
mo (33.3-NR) with sunitinib. Pembro + axi improved PFS
(HR, 0.71 95% CI, 0.60-0.84; P< 0.001; 24-mo PFS rate,
38% vs 27%) vs sunitinib. For pembro +axi vs sunitinib
respectively, median (95% CI) PFS was 15.4 (12.7-18.9)
vs 11.1 mo (9.1-12.5); ORR was 60% vs 40% (P< 0.0001);
CR rate was 9% vs 3%; and median DOR was 23.5 mo
(range 1.4+ to 34.5+) vs 15.9 mo (range 2.3-31.8+). In
general, the pembro + axi benefit was observed in all subgroups
tested, including IMDC risk and PD-L1 expression
subgroups. Post-hoc landmark analysis at 6-mo
showed that pts on pembro + axi with 80% target lesion
reduction had OS similar to that of pts with CR per RECIST
v1.1 based on Kaplan-Meier curves and HR 95%
CI estimates (0.20 0.05-0.84 vs. 0.10 0.01-0.76, respectively)
vs pts with 0-30% target lesion reduction. No
new safety signals were observed.
Conclusions: Pembro + axi continued to demonstrate
superior and durable antitumor activity vs sunitinib in
pts with first-line aRCC with a 27-mo median follow up;
no new safety signals were observed. Clinical trial information:
NCT02853331.
Research Funding: Merck Sharp & Dohme Corp., a subsidiary
of Merck & Co., Inc., Kenilworth, NJ, USA
n Abstract 5003: Phase II study of the oral HIF-2
inhibitor MK-6482 for Von Hippel-Lindau disease–
associated renal cell carcinoma. Eric Jonasch, Frede
Donskov, Othon Iliopoulos et al.
Results: As of December 6, 2019, 61 pts were enrolled;
median (range) age was 41 years (19-66) and most pts
38 Kidney Cancer Journal
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