Real world experience of Nivolumab therapy in Metastatic Renal Cancer patients: a 3 year multi-centre review

Date 30 September 2019
Event ESMO 2019 Congress
Session Poster Display session 3
Topics Renal Cell Cancer
Presenter Joanna Hack
Citation Annals of Oncology (2019) 30 (suppl_5): v356-v402. 10.1093/annonc/mdz249
Authors J. Hack1, S.L. Hill2, J. Broadfoot3, C. Chau4, T. Geldart5, J. Gale1, K. Fife6, M. Wheater7
  • 1Oncology Department, Portsmouth Hospitals NHS Trust, PO63LY - Portsmouth/GB
  • 2Oncology Department, Southampton General Hospital, SO166yd - Southampton/GB
  • 3Oncology Department, Royal Bournemouth Hospital, BH77DW - Bournemouth/GB
  • 4Oncology Department, Portsmouth Hospitals NHS Trust, PO6 3LY - Portsmouth/GB
  • 5Oncology Department, Royal Bournemouth Hospital, BH7 7DW - Bournemouth/GB
  • 6Oncology Department, Cambridge University Hospitals NHS Foundation Trust - Addenbrooke's Hospital, CB2 0QQ - Cambridge/GB
  • 7Oncology Department, Southampton General Hospital Southampton University Hospitals NHS Trust, SO16 6YD - Southampton/GB

Abstract

Background

In the UK renal cancer has an incidence of around 12600 cases per year. Nivolumab is an anti-PD1 checkpoint inhibitor, which was approved in the UK for second or subsequent line treatment of advanced renal cancer in 2016. The aim of this study was to evaluate a regional experience of nivolumab use in this setting.

Methods

A retrospective analysis was undertaken of patients who commenced nivolumab as monotherapy for advanced renal cancer at three Cancer Centres in South Central England between February 2016 and April 2019. Information was collated from electronic patient records and e-prescribing systems. Information was gathered on patient demographics, Heng (IMDC) prognostic scores, previous treatments, treatment toxicity, use of steroids and radiotherapy during treatment, physician assessment of response and survival data.

Results

109 eligible patients were identified. The average age was 59 with 72.5% of patients male. 67.9% (74/109) of patients had prior nephrectomy and 50.5% (55/109) had metastatic disease at diagnosis. 82.6% (90/109) had pure clear cell histology. 63.3% (69/109) received nivolumab as second-line treatment, 27.5% (30/109) as third-line treatment and 9.2% (10/109) as fourth-line and beyond. At the start of treatment 19.41% (19/103) had a ‘favourable’ risk Heng score, 61.2% (64/103) had an ‘intermediate’ risk and 18.3% (19/103) had a ‘poor’ risk. The number of Nivolumab cycles received ranged from 1-69, with a mean of 11 and median of 5. 45.9% of patients experienced toxicity of any grade, with 16.5% experiencing grade 3/4 toxicity. 24.8% (28/109) received radiotherapy and 40.4% (44/109) received steroids during nivolumab treatment. At response assessment 31.5% showed a response to nivolumab, 9.3% had stable disease and 59.3% had disease progression. From the start of nivolumab treatment median progression-free survival was 5.4 months, and the 12-month overall survival rate was 56.88%. 22.6% (24/109) are still receiving nivolumab.

Conclusions

This review has given us important real-world data on the safety and efficacy of nivolumab which reflects the findings of the pivotal phase 3 trials that led to it’s use. Further analysis will allow us to see the effect of different factors on these outcomes.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.