SAN FRANCISCO—Immune checkpoint inhibitor (ICI) treatment for metastatic renal cell carcinoma (mRCC) is safe and efficacious in a real world setting, investigators concluded in a presentation at the 2020 Genitourinary Cancers Symposium.
In a single-center study of 177 patients with mRCC who received at least a single dose of ICI, Roy Elias, MD, and colleagues at the University of Texas Southwestern Medical Center in Dallas demonstrated that the cohort had a median time to next treatment of 8.9 months and median overall survival time of 26.7 months.
Due to the timing of ICI approval, the majority of the patients in this cohort were treated with nivolumab monotherapy in the second or later line. The outcomes, including objective response rates, progression free survival, and overall survival were similar to what had been seen in clinical trials.
Immune-related adverse events (irAE) occurred in 77 patients (43.5%), with 42 (23.7%) experiencing a grade 3 or 4 irAE, as expected.
On multivariable analysis, only the number of organs involved and non-ccRCC subtype predicted outcomes, Dr Elias’ team reported. Each additional organ involved was significantly associated with a 27% increased risk of starting the next treatment and 49% increased risk of death. Non-ccRCC subtype was significantly associated with a 2.6-fold increased risk of starting the next treatment and 3.8-fold increased risk of death.
“Interestingly, clinical and laboratory variables, including the IMDC risk score, did not consistently predict outcomes in this heterogeneous cohort. This highlights the need for molecular biomarkers which can guide management,” the investigators concluded in their study abstract.
Of the 177 patients, 140 (79.1%) had intermediate- or poor-risk disease based on IMDC criteria and 149 (84.2%) had clear cell RCC (ccRCC). With regard to ICI, 127 (71.8%) received nivolumab alone, 40 (22.6%) received ipilumumab plus nivolumab, and 10 (5.6%) received a combination of an ICI plus a tyrosine kinase inhibitor.
Elias R, Levonyack N, Christie A, et al. A real world experience of immune checkpoint inhibitors (ICI) in metastatic renal cell carcinoma (mRCC). Presented at the 2020 Genitourinary Cancers Symposium held February 13 to 15 in San Francisco. Abstract 647.
This article originally appeared on Renal and Urology News