Dr. Walter Stadler, an oncologist at the University of Chicago and a member emeritus of the Kidney Cancer Association’s Medical Steering Committee, spoke to Targeted Oncology about updates and changes in how kidney cancer is treated. Read an excerpt:
TARGETED ONCOLOGY: How has the setting of kidney cancer changed over the last few years?
STADLER: Well, I think that if I zoom out a little bit here and look at what’s happened over the last few decades, it’s been nothing short of remarkable. I started my career with essentially no active therapies, aside from high-dose IL-2 [interleukin 2], which was very toxic and benefited only a very small proportion of patients. We now have a number of PDGFR inhibitors, we have a number of immune checkpoint inhibitors, and we have hypoxia-inducible factor (HIF) inhibitors emerging very rapidly. So, I think that the fact that we’ve moved from essentially no therapy to trying to discuss which one of several treatments might be best for a specific patient is quite an impressive development over the last 2 decades.
TARGETED ONCOLOGY: What therapies do you prefer to use for patients in this setting in the first line?
STADLER: I think in the first line setting, we think about [patients with] good prognosis versus intermediate/poor prognosis. I think in the good prognosis patients, our options include surveillance because some of these patients do well for long periods of time. [Our options] include metastatic site directed therapy with either surgery or radiotherapy, things like stereotactic body radiotherapy. It may include things like single agents for which there’s good data with PDGFR inhibitors. We can think about using combination therapy with an immune checkpoint inhibitor or a PD-1 inhibitor plus a PDGFR inhibitor.
I think for initial therapy of the intermediate and poor prognosis patients, what we’re really looking at is either combination treatment with a PD-1 checkpoint inhibitor and PFGFR inhibitor, or dual checkpoint inhibitor therapy with a CTLA-4 and a PD-1 inhibitor. Of which, the only combination that’s available is ipilimumab [Yervoy] and nivolumab [Opdivo].
Read the full interview at Targeted Oncology: Expert Insights on the Evolving Treatment Paradigm During Kidney Awareness Month.
Learn more about kidney cancer treatment with the KCA’s Just Diagnosed Toolkit.