Everolimus-induced pneumonitis as predictor of outcome in patients with metastatic renal cell carcinoma

Background

Previous research has shown that certain treatment related adverse events correlate with clinical efficacy of targeted therapies in the treatment of patients with metastatic renal cell carcinoma (mRCC). A well-known class effect of mammalian target of rapamycin inhibitors is non-infectious pneumonitis. We evaluated the possible association of pneumonitis with outcomes in mRCC patients treated with everolimus.

Methods

303 consecutive patients with mRCC were treated in a single university hospital cancer center. We identified 85 patients (28.1%), who received sequential everolimus after first-line targeted therapy. Treatment-induced adverse events including pneumonitis were assessed and analyzed for the possible association with outcome using the Kaplan-Meyer method and Cox regression adjusted for known risk factors.

Results

33 patients (38.8%) developed clinical symptoms and radiological findings of pneumonitis during everolimus treatment. In univariate analysis patients with pneumonitis had both a longer overall survival (OS) (19.67 vs. 8.50 months; P 

Conclusions

Our results suggest that pneumonitis may be associated with everolimus treatment efficacy. Further validation studies are warranted to confirm our findings.

Clinical trial identification

Legal entity responsible for the study

Comprehensive Cancer Center, Helsinki University Hospital

Funding

Helsinki University Hospital and grant from Novartis

Disclosure

P. Penttila: P. Penttila has received honoraria from Novartis. K. Peltola: K. Peltola has received honoraria from Novartis, BMS, Pfizer, Amgen, Astellas, Sanofi, Merck, Eli Lilly. P. Bono: P. Bono has received honoraria from Pfizer, Novartis, Orion Pharma, BMS and MSD. PB has received research funding from Novartis. All other authors have declared no conflicts of interest.