What Is the Most Exciting Ongoing Clinical Trial in RCC?

A roundtable discussion, moderated by Monty Pal, MD, of the City of Hope, focused on updates in renal cell carcinoma (RCC), including treatment in both the frontline and adjuvant settings. Dr. Pal was joined by a panel that included Daniel George, MD; Brad McGregor, MD; and Cristina Suárez Rodríguez, MD.

In the final segment of the roundtable series, the panel discusses exciting ongoing clinical trials, including 304, TiNivo-2, PDIGREE, and more.

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Dr. Pal: In the last 2 minutes here, I’m going to put you guys on a spot, but I’ll take the first hit. I’m going to ask you what you think the most exciting trial is right now that’s ongoing in renal cell carcinoma.

I’ll take first dibs on that. I’m going to say it’s 304, which is this trial of XL092/nivolumab versus sunitinib. I’m really hoping it addresses this void of non-clear cell kidney cancer. If we can bump those recommendations with a choice from a definitive phase 3 trial, I think that’s going to be powerful. Brad, can I turn to you next?

Dr. McGregor: I think CONTACT-03 and TiNivo-2 are going to be critical. We don’t really have the answer to what is the role of continued immunotherapy beyond progression? I think hopefully those trials would provide some really important data.

Dr. Pal: Dan?

Dr. George: I’m going to say PDIGREE, but I’m going to say not for what you think. Regardless of what PDIGREE shows as a result, the fact that we can start a different trial design where before disease progression we can add to a regimen, I think is such an important paradigm. When I think about how we’re going to make progress in this field, working toward a minimal disease state, whether it’s patients get a deep response or a partial response, we need to find out how to maximize this clinical benefit before they progress. So I really like the PDIGREE design, a trailblazing trial of being able to show that we can almost like hematologic malignancies start looking at induction or initial therapy and then subsequent therapies before progression.

Dr. Pal: Makes sense. Cristina, you get the final word, my friend.

Dr. Suarez: I like the 304 trial because I think it’s really an unmet need. We don’t have anything good for non-clear cell patients, and we really need something. We really randomized, phase 3 trials in this population, but I agree with both of you that for different reasons, both are very, very interesting. We do need to an answer on what to do after immuno-oncology (IO) combinations. PDIGREE has a very, very smart design. I love the design of PDIGREE. I’m not going to say 1 or the other, but I think every trial is very important in their settings.

Dr. Pal: Well said. I think we’ve reached a lot of good consensus here. That’s absolutely terrific.

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Watch more RCC roundtable videos.