Strengthening immune therapy in kidney cancer the goal of the KEYPAD clinical trial

People with kidney cancer may meet a surgeon, have their cancer removed, and many people then are thankfully free of the cancer. If kidney cancer spreads and grows, then more treatments are needed. Treatments for advanced kidney cancer have evolved quickly in the last few years, with treatments that boost the immune system now having a key role in treatment. As immune therapies have been shown to be effective in some people, ANZUP’s research focuses on strengthening these therapies, trying to make them work for more people and for longer.

In 2017 ANZUP opened a kidney cancer clinical trial called KEYPAD. This study is testing if a drug often used to treat osteoporosis, (thinning of the bones), can strengthen the outcomes of immune therapy for people with clear cell renal cell carcinoma (the commonest form of kidney cancer). Immune therapies have been shown to be effective in about a quarter of patients with clear cell renal cell carcinoma after a standard treatment (sunitinib or pazopanib) is no longer working. In the KEYPAD clinical trial, people with advanced clear cell kidney cancer will be offered treatment with two medicines (in the form of antibodies, a type of protein), pembrolizumab and denosumab. The study will question if these drugs taken together can increase the ability of the body’s immune system to recognize and control kidney cancer.

“What we’re learning about immune treatments is that they don’t necessarily depend on the kind of cancer; rather they depend on whether the person’s immune system is ready and waiting to attack the cancer,” says Associate Professor Gedye. “The new generation of immune therapies try to teach a new trick to the immune system, to recognise and attack the cancers in your body.”

Blood and cancer samples will also be collected from the trial patients to better understand why some people benefited from this combination of treatment and why some people did not. It is hoped that there is an improvement in treatment without any change in side effects.

The recruitment aim for the KEYPAD study is a total of 70 participants. Even throughout the uncertainties posed by COVID-19, recruitment has remained steady. Only 19 more patients are required to join the study to complete recruitment. To find out more about the trial go to page 51 or visit https://anzup.org.au/clinical-trial/keypad/

If you would like further information about this study and help to determine if this clinical trial will improve outcomes for kidney cancer patients, then please speak with your doctor.

The KEYPAD study is a really interesting clinical trial where we’ve worked with MSD and Amgen Australia to see whether treating people with a drug that has been used for protecting their bones will make immune therapy work better for people who have the commonest form of kidney cancer – clear cell renal cell carcinoma.

Craig Gedye KEYPAD trial eligibility

Adults with unresectable or metastatic clear cell renal cell carcinoma with no history of significant autoimmune disease and no previous treatment with immunotherapy. If you think you are eligible for this trial please talk to your doctor.