Durability of Response with First-Line Combined Immune Checkpoint Inhibitor Therapy Compared to Checkpoint Inhibitor with VEGFR-TKI in Advanced Clear Cell Renal Cell Carcinoma

Over the past several years, four regimens incorporating immune checkpoint inhibitors have become widely used in the front-line setting to treat metastatic clear cell renal cell carcinoma: nivolumab with ipilimumab, axitinib with pembrolizumab, cabozantinib with nivolumab, and lenvatinib with pembrolizumab. These regimens all demonstrated favorable response rates and survival outcomes compared to sunitinib in phase III trials. As these data have matured, nivolumab with ipilimumab has been most clearly associated with durable long-term disease response and stable survival benefit. Moreover, responses obtained using nivolumab with ipilimumab are more likely to persist after treatment discontinuation compared to regimens containing a VEGFR-TKI. These outcomes underline the value of using nivolumab with ipilimumab to pursue durable response in patients with advanced clear cell renal cell carcinoma.