Renal medullary carcinoma (RMC) is one of the most aggressive forms of kidney cancer, and traditional treatments are often not very effective, resulting in a need for new strategies. Recent studies have shown the potential therapeutic role of immune checkpoint inhibitors (ICIs) for the treatment of RMC.
Researchers from the University of Texas MD Anderson Cancer Center and West Virginia University carried out the first evaluation of ICIs in patients with RMC to determine their effectiveness.
A small group of 5 patients with locally advanced or metastatic RMC were administered pembrolizumab 200 mg intravenously every 21 days as part of a phase 2 basket trial. Tumor tissues were evaluated for programmed cell death ligand 1 (PD-L1) expression and tumor-infiltrating lymphocyte (TIL) levels. Targeted next-generation sequencing was used to assess somatic mutations.
The majority of patients (60%) had metastatic disease at diagnosis, and all patients had advanced disease. Despite treatment with pembrolizumab, each patient experienced rapid disease progression, with a median time to progression of 8.7 weeks. One patient experienced sudden clinical progression immediately after treatment initiation and was pulled from the trial less than 1 week after receiving pembrolizumab.
This evaluation of pembrolizumab for the treatment of RMC showed no evidence of clinical activity, irrespective of PD-L1 or TIL levels.