Based on the negative results of the phase III, double-blind COSMIC 313 trial, the American Society of Clinical Oncology has updated its rapid recommendations for managing metastatic renal clear cell cancer (ccRCC). Cabozantinib 40 mg once daily, nivolumab 3 mg/kg once every 3 weeks for 4 cycles, and ipilimumab 1 mg/kg once every 3 weeks for 4 cycles (IpiNivoCabo) increased progression-free survival. Still, the ASCO concludes that the increased frequency of grade 3 and 4 adverse events outweighed the benefits of triplet therapy.
The revised recommendation 3.6 now reads: “Treatment with IpiNivoCabo is not recommended for patients with metastatic ccRCC. Patients interested in triplet therapy should enroll in a clinical trial (Type: Evidence based; harms outweigh the benefits [harms of IpiNivoCabo outweigh the benefits]; Evidence quality: High; Strength of recommendation: Strong).”
A complete list of ASCO guidelines for genitourinary cancer is available online.