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March 3, 2022Journal of Clinical OncologyOpen Access

Prospective Cardiovascular Surveillance of Immune Checkpoint Inhibitor–Based Combination Therapy in Patients With Advanced Renal Cell Cancer: Data From the Phase III JAVELIN Renal 101 Trial

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Why the study?

Immune checkpoint inhibitors and VEGFR inhibitors can cause cardiovascular events, raising concern that combination therapy could lead to MACE.

Does avelumab plus axitinib compared to sunitinib increase major adverse CV events in patients with advanced renal cell carcinoma, and what is the value of prospective cardiac monitoring?

Population

Patients with advanced renal cell carcinoma

Comparison

Avelumab plus axitinib vs sunitinib

Design

Phase III randomized trial with prospective serial cardiac monitoring

Authors

BRBrian I. RiniJMJavid J. MoslehiMBMarc P. Bonaca

Discussion

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Overview

Baseline troponin T elevation signals higher MACE risk with avelumab-axitinib; questions routine on-treatment LVEF monitoring in asymptomatic patients.

Structured PICO

Does avelumab plus axitinib compared to sunitinib increase major adverse CV events in patients with advanced renal cell carcinoma, and what is the value of prospective cardiac monitoring?

P
Population
Patients with advanced renal cell carcinoma
I
Intervention
Avelumab plus axitinib
C
Comparator
Sunitinib
O
Outcome
Major adverse CV events (MACE)safety

In patients receiving avelumab plus axitinib for advanced renal cell carcinoma, high baseline troponin T levels may predict MACE, but routine on-treatment LVEF monitoring in asymptomatic patients has no clinical value.

Cite This Study

Rini et al. (2022) studied this question.

synapsesocial.com/papers/6a85648468d2ad262cd594fehttps://doi.org/10.1200/jco.21.01806
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pembrolizumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma2019 · 3,487 citations
  2. 2Cardiovascular toxicities associated with immune checkpoint inhibitors2019 · 520 citations
  3. 3Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the chronic renal insufficiency cohort (CRIC)2013 · 144 citations
  4. 4Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma2020 · 7,545 citations
  5. 5Avelumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma2019 · 2,590 citations