Nivolumab in combination with cabozantinib is in development for first-line treatment of metastatic renal cell carcinoma (mRCC). Renal cell carcinoma is the most common form of cancer that originates in the kidney. It may occur due to the mutation of cells in the kidney’s filtering system. RCC often has few symptoms, so may be diagnosed quite late, and tend to spread to other organs quite early. There are many types of RCCs and each type is derived from a different cell lineage and has its own distinct characteristics. In mRCC, the tumour has spread beyond the regional lymph nodes to other parts of the body.
Nivolumab works by improving the activity of white blood cells thereby increasing the ability of the immune system to kill cancer cells. Cabozantinib works to stop signals that cancer cells use to divide and grow. It is thought that when used in combination, both drugs may be more effective than each drug on its own. If licenced, nivolumab in combination with cabozantinib may improve long-term outcomes in mRCC patients who currently have limited treatment options.
Carfilzomib, is a proteasome inhibitor. Proteasome is a system within the cells that breaks down proteins that are no longer needed. Cancer cells have an increased need to produce and break down proteins as they multiply rapidly. When carfilzomib stops the proteasome from breaking down proteins in the cancer cells, the proteins build up and cause the cells to die, slowing down the growth of the cancer. The addition of daratumumab and dexamethansone to carfilzomib may potentially improve outcomes and reduce side effects in patients with relapsed and/or refractory MM who have received prior therapies.