The RCC rat race.

July 21, 2017. It’s been a big summer for renal cell carcinoma (RCC). In April, the ROPETAR trial confirmed VEGF inhibitor monotherapy remains the standard for metastatic disease: rotating pazopanib (VEGFi) with everolimus (mTORi) in an attempt to skirt side effects did not achieve superior survival outcomes...nor did it lessen toxicity. On the adjuvant front, the ARISER trial published this month showed no improvement with the use of girentuximab (a novel antibody developed to target a cell surface antigen fairly specific to RCC) following complete resection of high risk RCC (pT3-4, pN+, or G3). One reason for lack of added benefit with girentuximab is undoubtedly due, at least in part, to the unprecedented DFS outcomes across the entire study population, with over half of patients free of disease at 5 years. Meanwhile, the Phase I CheckMate 016 trial evaluating response rate (RR) of previously treated metastatic RCC to combo immunotherapy with nivolumab (25% RR as monotherapy) + ipilimumab (5-12% RR as monotherapy) resulted in an unparalleled 2-year OS of ~70% with a RR of a whopping 40%. And for now that’s...check mate.