During a recent PW Podcast episode, we spoke with David Cella, PhD, Professor at the Robert H. Lurie Comprehensive Cancer Center of North- western University and presenter of results from the CheckMate-9ER Trial—which assessed combi- nation nivolumab and cabozantinib as first-line treatment for advanced and metastatic renal cell carcinoma—during the 2021 ASCO Genito- urinary Cancers Symposium. Following is a sum- mary of that interview:
What were the health-related quality of life outcomes from the CheckMate-9ER trial?
Historically in oncology, the more effective therapies—because they tend to add a drug to an existing combination—have more toxicity and side effects that are a little harder on patients despite the more clinically effective treatment. In CheckMate-9ER, that’s not what we found at all. We found that the newer, more effective combination of nivolumab and cabozantinib was not only clinically superior in terms of progression-free survival and overall survival, but it was also superior to sunitinib from the patient’s perspective in terms of their symptoms and side effects.
What tools were used to measure these outcomes?
These findings were based on results from the Fact Kidney Symptom Index (FKSI-19) and the health preference questionnaire EuroQOL, a five-item measure of value that one places on their overall health. On both measures, we found that nivolumab-cabozantinib combination was superior to sunitinib during the almost 2 years of follow-up.
How would you place CheckMate- 9ER results in perspective with similar studies?
In immune oncology, these immunotherapy- oriented drugs have revolutionized cancer care, in particular, renal cancer care. So, the news is very good for patients with kidney cancer, relative to where things were 15-20 years ago. It’s exciting to see that people can not only do better and live longer, but also not have as many of the adverse effects. It’s not that these treatments are without adverse effects. They do have some, but they’re not as harsh as with some other treatments. Also unique with these treat- ments is that standard measures of disease progression—tumors getting larger or metas- tasizing—are not always necessarily a reason to stop with therapy. If a patient is doing well, they can continue on therapy, and in many cases, get continued benefit.
What are the next steps with this study?
The next step with CheckMate-9ER is to assess the overall picture, combining the health- related quality of life data with the clinical data to determine if putting it all into one analysis shows the same kind of benefit, or perhaps even more benefit.