Dr Jianbo Wang speaks to ecancer about a phase II trial of nivolumab, ipilimumab and cabozantinib in patients with brain metastases from renal cell carcinoma.

Brain metastases occur in about 12 percent of patients with advanced kidney cancer and are associated with poor outcomes.

Standard treatment options are limited, often involving surgery or radiation, and prospective systemic therapy data are scarce.

This phase II trial evaluated the combination of cabozantinib, nivolumab, and ipilimumab in patients with untreated brain metastases from renal cell carcinoma.

Among 11 patients enrolled, the regimen showed encouraging intracranial activity, with a median intracranial progression-free survival of 12 months and an intracranial objective response rate of 54.5 percent, including 4 complete responses.

Extracranial responses were also observed, with a median extracranial progression-free survival of 8.5 months and an overall response rate of 36 percent.

The combination was generally well tolerated, with minimal central nervous system toxicities.

Dr Wang says that these results suggest that cabozantinib plus dual immune checkpoint blockade is a promising strategy for managing brain metastases in renal cell carcinoma.