Atezolizumab plus cabozantinib versus cabozantinib alone for advanced renal cell carcinoma after ICI treatment

Immune checkpoint inhibitors are the standard of care for first-line treatment of patients with metastatic renal cell carcinoma. Optimal treatment after progression on this therapy is unknown. The multinational phase 3 CONTACT-03 trial evaluated addition of atezolizumab to cabozantinib in this setting. Patients with locally advanced or metastatic renal cell carcinoma whose disease had progressed with immune checkpoint inhibitors were randomized to atezolizumab plus cabozantinib or cabozantinib monotherapy. The addition of atezolizumab to cabozantinib did not improve clinical outcomes and led to increased toxicity. The authors conclude that these results should discourage sequential use of immune checkpoint inhibitors in patients with renal cell carcinoma outside of clinical trials.