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Medicine Matters oncology

KEYNOTE-426 is a randomized clinical trial in metastatic kidney cancer for patients who are randomized to receive axitinib with pembrolizumab or sunitinib, what represented the standard of care. And the results presented last year and published in The New England Journal show a clear benefit, in terms of progression-free and overall survival to the combination of pembrolizumab and axitinib.



One of the key questions when those data were presented were, well, how well does it do long term? And so that's part of what we sought to answer in this update to the KEYNOTE-426 data at this year's ASCO. So now, we have about two years of follow-up on all patients, and we see the curves continue to remain separated, with the survival benefit, axitinib plus pembrolizumab over sunitinib.



We also did a depth-of-response analysis and showed that the deeper the response to patients on the combination therapy, the better their survival. And patients with a deep partial response, shrinkage of greater than 80% of their target lesions, had about the same survival as someone with a complete response. So this helps us gauge how we prognosticate in terms of kidney-cancer treatment.



That exploratory analysis does not really inform how we practice. I think the long-term data are what really emphasize the treatment of initial therapy as being very important. And these data do support axitinib with pembrolizumab as being frontline standard of care in metastatic kidney cancer, based on long-term follow-up. More follow-up is coming and will be equally important.