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An Expert Expands on What Drives ‘Exceptional’ Responses to RCC Treatment

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Dr. David A Braun delved into detail on the molecular factors driving exceptional responses to immunotherapy in metastatic clear cell renal cell carcinoma.

In a clinical trial conducted by experts in the metastatic clear cell renal cell carcinoma (ccRCC) — a type of kidney cancer — treatment space, investigators highlighted the importance of tailoring immunotherapy approaches based on molecular and immune features to optimize outcomes for patients with mccRCC.

Findings from the investigation showed that specific molecular factors, such as having a higher load of clonal neoantigens or robust B-cell receptor signaling, drove patients with this disease to have exceptional responses to their immunotherapy, according to Dr. David A. Braun, a co-author of the study.

In an interview with CURE®, Braun delved into detail on the molecular factors driving exceptional responses to immunotherapy in metastatic ccRCC, sharing how specific treatments may work better for certain patients. Braun currently serves as as an Assistant Professor of Medicine, Medical Oncology, and is a Louis Goodman and Alfred Gilman Yale Scholar, at the Yale School of Medicine, and a member of the Center of Molecular and Cellular Oncology at Yale Cancer Center, in New Haven Connecticut.

Read on to see what he had to say about the study!

Transcript:

We think very deeply about what is it that patients are sort of ultimately looking for, and to [get the] best answer, you have to go to the patients themselves. Dena Battle, who's a wonderful advocate in the kidney cancer community, runs a group called KCCure. She's done these surveys of what patients are looking for [in] the treatment of [their] metastatic cancer, and when you look at it, there's a lot of things that are important and that are meaningful. But the top things are trying to get to long term durable responses, and in an ideal world, cures. [We are] trying to get to a point where patients have long term disease control.

In the pure targeted therapy era, that wasn't an achievable thing, necessarily, for kidney cancer, at least for the far majority of patients. Even in the modern immune checkpoint era, the majority of patients aren't able to get that level of benefit, but some are. The key is, now that we're starting to understand the factors that might allow some patients to have those exceptional responses to this immune therapy, the hope is that we really can learn from that; however, we do have to push this forward.

How can we learn from [our study] to make it not so exceptional [and a more widely accepted standard], so that we understand the factors that can lead to these long term, durable responses, the ones that patients are really hoping for and asking for? How can we rationally design our next set of experiments and ultimately clinical trials to move towards those exceptional responses? I think that's the goal of this kind of research.

Transcript has been edited for clarity and conciseness.

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