Is There a Role for “Salvage” Immunotherapy in Advanced Renal Cell Cancer?

For untreated metastatic clear cell renal cancer, immune-checkpoint–based combinations with ipilimumab and nivolumab or an immune checkpoint inhibitor and a VEGF-tyrosine kinase inhibitor (TKI) are first-line standard-of-care options. Most patients, however, either fail to respond or ultimately experience disease progression, and some receive subsequent VEGF-TKI therapy. Immune checkpoint-based therapies are used as salvage therapy by some clinicians, but there is limited evidence for this practice, and it is not an established standard of care.

Based on provocative phase 2 results on combined PD-L1 and VEGF-TKI therapy in the salvage setting, investigators conducted an industry-sponsored, open-label randomized phase 3 trial comparing treatm…