Nivolumab plus cabozantinib for advanced renal cell carcinoma

Plain language summaryKidney cancer that has spread to organs and other parts of the body outside of the kidney remains a challenging disease to treat. The treatment of advanced kidney cancer has changed over the past decade with the approval of oral therapies called tyrosine kinase inhibitors and more recently immunotherapy, which utilizes the immune system to treat cancer. A new combination therapy employing cabozantinib and nivolumab has been shown to help patients with advanced kidney cancer live longer and have improvements in quality of life. This new combination therapy is now commonly used to treat advanced kidney cancer. Advanced renal cell carcinoma (RCC) remains a challenging oncologic disease to treat despite advancements in therapeutics. Nonetheless, the development of tyrosine kinase inhibitors (TKIs) and immunotherapy has drastically altered the treatment landscape for advanced RCC over the past decade. The current standard-of-care treatment for advanced RCC involves combination TKI and immunotherapy regimens including cabozantinib and nivolumab as studied in the CheckMate 9ER trial. This review summarizes the preclinical and clinical evidence that led to the CheckMate 9ER study, as well as pertinent study aspects such as treatment efficacy, adverse events and patient-related outcomes.