Anti-PD-L1 Combinations Show Reduced Risk of Progression for mRCC Compared With Sunitinib

By Emily Menendez - Last Updated: July 10, 2023

Researchers conducted a meta-analysis to assess the association of anti-programmed cell death ligand 1 (PD-L1) treatment combinations with survival and response rates in patients with metastatic renal cell carcinoma (mRCC).

They analyzed the IMmotion150 and IMmotion151 trials, along with the JAVELIN Renal 101 trial, to assess the overall survival (OS), progression-free survival (PFS), and overall response rates (ORRs) of anti-PD-L1 combinations. Summary hazard ratios (HRs) and odds ratios (ORs) were analyzed, with a two-sided P<.05 indicating statistical significance.

Atezolizumab plus bevacizumab and avelumab plus axitinib were administered in the intervention groups (n=1100; 784 males [71.3%], 316 females [28.7%], mean [SD] age, 62 [0.45] years), and sunitinib was administered in the control group (n=1107; 776 males [77.1%], 231 females [22.9%], mean [SD] age, 61 [0.58] years).

In the intervention groups, the combination of anti-PD-L1 agents was not associated with a risk of death (HR, 0.88; 95% CI, 0.75-1.03; P=.11) but was associated with a reduced risk of progression (HR, 0.78; 95% CI, 0.69-0.88; P<.001) and no improvement in OS (HR, 0.84; 95% CI, 0.67-1.05; P=.12) or ORR (OR, 1.63; 95% CI, 0.79-3.35; P=.19) when compared with sunitinib. However, PFS (HR, 0.66; 95% CI, 0.56-0.79; P<.001) and ORR (OR, 2.28; 95% CI, 1.17-4.46; P=.02) were favorable.

Evidence from the IMmotion010 trial supports the lack of effectiveness of anti-PD-L1 agents for renal cell carcinoma; the study found that adjuvant atezolizumab did not affect disease-free survival in intermediate-to-high-risk resected or stage M1 cancer in patients with no evidence of disease.

The researchers noted that anti-PD-1 agents may be more effective than anti-PD-L1 agents for the treatment of mRCC.