Sunday, February 17, 2019

Drug combination may become new standard treatment for advanced kidney cancer

A combination of two drugs -- one of them an immunotherapy agent -- could become a new standard, first-line treatment for patients with metastatic kidney cancer, says an investigator from Dana-Farber Cancer Institute, reporting results from a phase 3 clinical trial.
Patients who received the immunotherapy drug avelumab plus axitinib, a targeted agent, had a significant advantage in progression-free survival compared with those who received sunitinib (Sutent), a targeted drug that has been a standard treatment for advanced clear cell renal cell carcinoma -- the most common form of kidney cancer.
While progression-free survival was improved with the combination treatment, additional follow-up is needed to show whether the two-drug therapy extends overall survival compared to the standard regimen.
The trial is the first pivotal study to combine avelumab with a drug that targets the vascular endothelial growth factor receptor (VEGFR). VEGFR blockers like sunitinib and axitinib are designed to starve tumors by disrupting their blood supply. Immunotherapy drugs such as avelumab -- which blocks an immune checkpoint called PD-L1 -- work by activating "exhausted" immune T cells so they can more effectively attack cancer cells.
The clinical trial involved 886 patients with previously untreated, advanced renal cell carcinoma that were randomized to receive the drug combination or sunitinib alone. See more

Sunday, February 10, 2019

Pharmacogenetic Testing

While numerous factors may influence patient responses to medications, treatment response likely depends on the relationship between the pharmacokinetics, pharmacodynamics, and pharmacogenetics for each individual patient. Pharmacogenetic testing can serve as a tool that provides information in terms of how genetic variability affects individual responses to medications.  Traditionally 4 common phenotypes designate how an individual will metabolize medications: normal or extensive metabolizers, poor metabolizers, intermediate metabolizers, and ultrarapid metabolizers. Practitioners need to understand the clinical effect of genetic polymorphisms in metabolizing enzymes. In discussing poor metabolizers for a medication that has an active parent compound, the potential clinical consequences in general include increased efficacy and the potential for lower doses to provide efficacy, or increased toxicity as a result of buildup of the active parent compound." 

Source: Clinical Pain Advisor