Kidney cancer patients have ‘more and more hope’ after promising Dana-Farber study

A promising new study out of Dana-Farber Cancer Institute showing that a three-drug combination slows the progression of advanced kidney cancer gives patients “more and more hope,” the lead researcher told the Herald on Wednesday.

Kidney cancer patients treated with the three-drug combo — a targeted kinase inhibitor added to a two-drug immunotherapy combo — had a 27% lower risk of progression or death compared to those on the two immunotherapy drugs.

“There had never been a study that showed the three drugs were superior to the two,” said Toni Choueiri, the director of the Lank Center for Genitourinary Cancer at Dana-Farber, and who’s the lead author of the COSMIC-313 study.

“This gives kidney cancer patients more and more hope,” he later added.

Rates of kidney cancer in the U.S. are on the rise, especially among men, and an estimated 82,000 Americans will be diagnosed with kidney cancer this year.

The COSMIC-313 study looked at the combination of three drugs: cabozantinib, nivolumab, and ipilimumab.

“This is the first study to evaluate a triplet therapy against a contemporary immune-oncology doublet control and it was designed to answer an important question of whether adding cabozantinib to dual checkpoint inhibition can improve outcomes for this patient population,” Choueiri said.

“The initial findings provide a clear look at the efficacy and safety profile of this triplet therapy and demonstrate a significant progression-free survival benefit,” the oncologist added.

The trial included 855 previously untreated patients with advanced or metastatic renal cell cancer, who were judged to be at intermediate or poor risk for survival.

Nivolumab and ipilimumab both work by blocking immune checkpoints, molecular “brakes” that prevent the immune system from attacking the cancer. Releasing the brakes allows the immune’s T cell army to invade the tumors and kill the cancer cells.

Cabozantinib inhibits several cancer-promoting pathways, and “may enhance response to checkpoint inhibitors,” said Choueiri, leading to a benefit when combined with nivolumab and ipilimumab.