Elizabeth Plimack, MD, MS, discussed the role of subsequent immunotherapy when analyzing the primary endpoint of overall survival for axitinib and pembrolizumab over sunitinib in patients with advanced renal cell carcinoma evaluated in the updated analysis of KEYNOTE-426.
Elizabeth Plimack, MD, MS, of the Fox Chase Cancer Center in Philadelphia, discussed the role of subsequent immunotherapy when analyzing the primary endpoint of overall survival for axitinib (Inlyta) and pembrolizumab (Keytruda) over sunitinib (Sutent) in the updated analysis of KEYNOTE-426 presented at the 2020 ASCO Virtual Scientific Program.
The most interesting to me is the overall survival endpoint. This continued to show significant benefit to axitinib and pembrolizumab over sunitinib despite the fact that many of the patients on the sunitinib arm were able to access subsequent immunotherapy. We talk about subsequent therapy a bit and as the study matures, more and more patients will come off of their primary therapy and move on to subsequent therapy. There was a large proportion of patients who did not receive subsequent therapy, but one of the points I made in the presentation is that that could be for a number of reasons. For some of our patients its actually because they don’t need subsequent therapy, their cancer is controlled. For other patients, subsequent therapy wasn’t appropriate because of their clinical condition. And other patients simply didn’t survive long enough to access it. Until we can really describe those different categories, it’s hard to know how crossover and access to subsequent immunotherapy really played a role in terms of the overall survival analysis. But I think the benefit is clear. The hazard ratio remains significant according to the primary endpoint standards over time.