The 3rd Immuno-Oncology

World Congress

Prof. Viktor Grünwald

Treatment of metastatic renal cell carcinoma (mRCC) has steadily evolved during the past decade. Today, 14 agents have received an EU-label for treatment of mRCC and are used in different lines of therapy. In 2019, ipilimumab + nivolumab (IO-IO) and axitinib + avelumab or pembrolizumab (TKI-IO) were approved for first line treatment and opened a new chapter in treatment perspectives in mRCC. Today’s first line treatment in mRCC offers a landscape with different outcome measures to achieve. While both strategies improved OS in patients, such benefit comes in different flavors. TKI-IO had profound impact on efficacy parameters, but complete response (CR) rates remain modest as of today. Furthermore, TKI-IO treatment comes at the expense of chronic TKI-toxicity, which impacts HR-QoL in patients. On the contrary, IO-IO had only modest impact on response rate, but achieved the highest CR rates reported so far. While IO-IO treatment is associated with its own AE spectrum, it achieves better HR-QoL compared to TKI treatment alone. Furthermore, the pivotal study has the longest follow-up and mirrors results seen in malignant melanoma, indicating a plateau. While the treatment landscape became more divers, early and late benefits can be identified with different treatment strategies, which are integral to our clinical decision making process. So, what is it going to be – CR or tumor control?