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Post-surgery immunotherapy extends disease-free survival for select patients with kidney cancer

Priscilla Lynch presents a round-up of some of the most topical research presented at this year’s ASCO Annual Meeting

Immunotherapy after surgery significantly improved disease-free survival (DFS) for patients with the most common type of kidney cancer, clear-cell renal carcinoma (RCC). A phase 3 international study, presented at the 2021 ASCO Annual Meeting, found that pembrolizumab could offer an effective treatment for patients currently with few other options.

KEYNOTE-564 is the first phase 3 study with a checkpoint inhibitor in the adjuvant setting to improve DFS for patients with high risk fully resected RCC. “Despite surgery, recurrence is common in clear-cell renal cell carcinoma, and should it recur, there are limited curative treatment options for patients. Given the success of pembrolizumab in the KEYNOTE-564 trial, this population may soon have a new standard of care,” said ASCO Chief Medical Officer and Executive Vice President Dr Julie R. Gralow.

At the study’s first interim analysis with 24 months median follow-up, the risk of disease recurrence or death was reduced by 32 per cent compared with placebo. The 24-month estimated DFS rate was 77.3 per cent with pembrolizumab, compared to 68.1 per cent with placebo. Overall, DFS benefit was consistent across subgroups.
The estimated preliminary OS rate at 24 months was 96.6 per cent with pembrolizumab and 93.5 per cent with placebo.
Grade 3-5 all-cause adverse events (AEs) were more common with pembrolizumab than placebo – 32.4 per cent versus 17.7 per cent with placebo, respectively. No treatment-related deaths occurred in the pembrolizumab arm.

“Pembrolizumab may provide a promising treatment for patients for whom there are few therapy options. KEYNOTE-564’s disease-free survival supports pembrolizumab as a potential new standard of care in the adjuvant setting to delay disease recurrence for patients with fully resected clear cell RCC,” said lead author Dr Tony Choueiri, who heads the Lank Centre for Genitourinary Oncology at the Dana Farber Cancer Institute.

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