Renal cell carcinoma (RCC) is the most common type of kidney cancer. RCC affects the lining of tiny tubes within the kidney which filter waste from the blood, making urine. Symptoms include blood in urine, feeling of lump or mass in the kidney area, weight loss, raised temperature and sweating, back pain on one side (below the ribs), tiredness, loss of appetite and a general feeling of poor health. The main treatment for RCC is surgery to remove the cancer by partly or totally removing the kidney. Some patients are at high risk of their cancer returning after surgery, especially those who have large tumours which may not be possible to totally remove.
Axitinib is a tablet taken twice per day which works by interfering with the growth of the blood vessels which supply blood to the cancer cells. In other types of cancer, Axitinib has been seen to slow down the growth and stop cancers from spreading to other parts of the body. Axitinib is already available to treat RCC which has already advanced or spread, however if axitinib is licenced for use after surgery to prevent the growth and spread of further tumours (as an adjuvant therapy), this may prevent the progression and spread of RCC to other sites of the body.
Selinexor is the first treatment option that targets XPO1, a protein that is responsible for exporting tumour suppressor proteins from the cell nucleus. It belongs to a new family of therapies called selective inhibition of nuclear export (SINE) compounds that blocks XPO1 leading to controlled death of myeloma cells. Currently there is no standard of care for the fifth line treatment of MM. Selinexor and low-dose dexamethasone are being developed as an oral treatment. If licensed, this combination could be an effective treatment option for a patient group with clear unmet need.