Commentary|Videos|September 3, 2025
Unknowns Remain in Frontline RCC Treatment and Adjuvant Approaches
Author(s)Bradley McGregor, MD
Fact checked by: Jonah Feldman
Bradley A. McGregor, MD, discusses the challenges shared by oncologists who treat renal cell carcinoma.
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Bradley A. McGregor, MD, director of Clinical Research for the Lank Center of Genitourinary Oncology at the Dana-Farber Cancer Institute, discusses the challenges shared by oncologists who treat renal cell carcinoma (RCC).
McGregor says that the participants he spoke to in a recent Case-Based Roundtable event all raised similar questions about treating their patients. At this time, a main challenge is that there are multiple tyrosine kinase inhibitor/immunotherapy and dual immunotherapy regimens that can be used in the front line that lack head-to-head comparisons. Because of this, it is crucial to share all trial data with the patient to help them make the right decision between different regimens to use.
In addition to treating stage IV RCC with combinations, oncologists hope to be able to prevent patients with localized disease from progression to more advanced disease. Pembrolizumab (Keytruda) has been approved in the adjuvant setting to reduce the risk of disease progression. Ongoing trials could support more treatment in patients with earlier-stage disease and can provide more guidance to physicians who are already using adjuvant therapy on how to proceed in this new population of pretreated patients as time goes on.
TRANSCRIPTION
0:10 | The conversations highlight that we all share the same challenges, and [we are] trying to make that right decision with the patient at that right time where we don't have randomized head-to-head trials. I think that's a universal challenge that we all face, and [we are] trying to make sure that, as the oncologist, we share the data with the patient so that we can help make that right decision, [which] is critical. I think another exciting point is that we have regimens for stage IV disease, but we're hopeful that with advances in therapy, we can prevent patients getting stage IV disease with the role of adjuvant therapy as well, with now pembrolizumab approved and ongoing trials looking to prove outcomes there.
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