“New Era” in Treating Metastatic Kidney Cancer
Results of two important studies bring good news to those who suffer from metastatic kidney cancer. “A new class of drugs is changing our approach to kidney cancer: the immune checkpoint inhibitors,” says Hans-Joerg Hammers, M.D., Ph.D., Assistant Professor of Oncology, who led the studies. “Over the last 10 years, treatment for metastatic kidney cancer focused primarily on targeting the fragile blood vessels that kidney cancers need for their growth. While this approach has had a significant impact on the care of our patients, durable disease control has been rare. The beauty of these new drugs is that they allow the body to launch a fierce and effective counter-attack to the cancer.”
“A new class of drugs is changing our approach to kidney cancer: the immune checkpoint inhibitors.”
Usually, one of cancer’s most effective strategies is to turn off the body’s immune response, “protecting itself against the patient’s own immune system,” says Hammers. But these drugs — specifically, antibodies that inhibit PD1 and its receptor PDL1, which is expressed on the immune cells — “have been shown to induce impressive, durable responses in a subset of patients with kidney cancer in early phase clinical trials.”
At the American Society of Clinical Oncology’s meeting this summer, Hammers presented data from the studies. In a multicenter trial, Hammers and colleagues demonstrated the efficacy and safety of the antibody nivolumab in more than 150 patients with kidney cancer; the largest number of these came from Johns Hopkins. “There was significant shrinkage of cancer in about 20 percent of the patients, the drug was very well tolerated, and the responses were very durable.”
The second study combined two different immune checkpoint inhibitors: nivolumab, targeting PD1, and ipilimumab, which inhibits another checkpoint called CTLA4. Hammers, who leads the medical oncology efforts in kidney cancer at Johns Hopkins, presented the data showing that the drugs were safe — and also that nearly half of the kidney cancer patients who received these drugs had significant shrinking of their cancer. “Many of these responses are still ongoing and likely durable,” says Hammers. “A new era in the treatment for metastatic kidney cancer has begun.”
Charles Drake, M.D. Ph.D., Associate Professor of Oncology, Immunology, and Urology adds that immune checkpoint inhibitors are also being used to treat other genitourinary malignancies, such as prostate and bladder cancer.