# CheckMate 214: nivolumab plus ipilimumab versus sunitinib in advanced renal cell carcinoma

Source: https://onco.cc/key-papers/paper-checkmate-214-nejm-2018/  
OnCo record `paper-checkmate-214-nejm-2018` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Dual immunotherapy with nivolumab and ipilimumab lengthened survival compared with sunitinib in intermediate- and poor-risk advanced kidney cancer, with about one in ten patients achieving a complete response that has proved durable over years.

## Summary

Phase 3 trial of 1,096 patients with untreated advanced clear cell renal cell carcinoma randomised to nivolumab plus ipilimumab (four doses) followed by nivolumab, or sunitinib, with co-primary endpoints in intermediate- and poor-risk patients.

In intermediate and poor risk, 18-month overall survival was 75 versus 60 percent (hazard ratio 0.63), response 42 versus 27 percent and complete response 9 versus 1 percent; favourable-risk patients had higher response to sunitinib at first analysis. Long-term follow-up shows sustained survival benefit.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: New England Journal of Medicine
- Year: 2018
- DOI: 10.1056/NEJMoa1712126
- Authors: Motzer RJ, Tannir NM, McDermott DF, et al.
- Findings: Intermediate and poor risk: 18-month overall survival 75 percent vs 60 percent; hazard ratio 0.63.; Complete response 9 percent vs 1 percent.
- What it means: Nivolumab-ipilimumab is a first-line standard for intermediate- and poor-risk clear cell kidney cancer, notable for durable complete responses and treatment-free intervals.
- Caveats: Favourable-risk patients showed no clear benefit.; Immune-related adverse events requiring high-dose steroids in about a third.

## Sources

- N Engl J Med 2018: https://doi.org/10.1056/NEJMoa1712126
- PubMed: https://pubmed.ncbi.nlm.nih.gov/29562145/

## Connected records

- cancers: [Clear cell renal cell carcinoma](https://onco.cc/cancers/clear-cell-rcc/)
- drugs: [Ipilimumab](https://onco.cc/drugs/ipilimumab/), [Nivolumab](https://onco.cc/drugs/nivolumab/), [Sunitinib](https://onco.cc/drugs/sunitinib/)
- trials: [CheckMate 214](https://onco.cc/trials/checkmate-214/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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