We learn from negative study results as well as from positive ones. Phase 3 study by Dana-Farber's Toni Choueiri, MD, shows that rechallenge with PD-L1 inhibitors in second-line therapy for advanced kidney cancer has no benefit.
Tesco 2023 we presented the contact three. That's the first randomized control trial in renal cell cancer. But I would dare to say in in solid tumor oncology where the question of re challenging with a PD uh L one inhibitor after prior progression on PD one or PDL one inhibitor is of any benefit. Perfect. We had data but never a randomized control trial in oncology where uh the same control uh drug was in both arms. So here we had after patients with metastatic RC, we use metastatic kidney cancer as the model here, patient whose tumor experienced progression on drug like and others were assigned to receive a TKI A standard TK I Carboy versus the same drug plus a drug A PDL one inhibitor they have not received, which in this case was Zuma. Uh one of the reason why Zuma is that that drug in patient who has never seen any treatment is active, it's not FDA approved but it's active resulting in a response rate of 25%. So what did we find? We found that there was absolutely no benefit in progression free survival, overall survival or response rate in adding a PDL one inhibitor and I would venture to say a immune checkpoint inhibitor in this case, targeting PD one or PDL one to um uh Furthermore, there was increased toxicity from the combination arm of Zuma and Cabos. I think the biggest question is how much this is applicable to other tumors.