Abstract 212P
Background
The standard practice for management of metastatic renal cell cancer (mRCC) patients in India has been sunitinib or pazopanib in the first line setting, and everolimus at progression. Nivolumab in the second line setting, showed a median overall survival (OS) of 26 months, 2year OS rate of 52% and objective response rate(ORR) of 26%; which was better than everolimus in the Checkmate 025 study. There is sparse data about nivolumab in Indian RCC patients.
Methods
This is a single centre, retrospective analysis, which included mRCC patients who received nivolumab between April 2016 to April 2019. The endpoints were ORR, OS and adverse events (AEs).
Results
31 patients of mRCC received nivolumab at 3 mg/kg or flat dose of 240mg. Median age was 60 years (22-82 years). There were 27 males and 4 females. 4 patients received first line nivolumab, and 27 patients as second line. 16 patients had earlier received sunitinib, 10 pazopanib, and 1 sorafinib. 3 patients (9.7%) achieved complete response(CR), 8(25.8%) achieved partial response, 8(25.8%)had stable disease and 12(38.7%)had progressive disease. The 3 patients with CR, received 18 doses, after which their treatment was stopped; and they continue to be in CR at followup of 36, 32 and 26 months respectively. 10 patients have completed more than 12 cycles. OS at 1 year is 60% and median OS has not been reached. The common AEs were fatigue in 8(25.8%), hypothyroidism in 6(19.3%), skin rash in 4(12.9%) and pneumonitis in 3(9.7%) patients. Colitis, arthritis, immune retinopathy, and myocarditis was each seen in 1 patient. Treatment was discontinued in 3 patients who developed grade 3 AEs.
Conclusions
With an ORR of 35.5%, nivolumab has replaced everolimus, and has become our standard second line regimen in mRCC. Achieving an OS at 1 year of 60% is the best we have seen in the second line setting. The most exciting impact has been the durable long lasting response seen (duration ranging 2-3 years) even after discontinuing treatment, in our 3 CR patients. This has prompted us to make 1 year of treatment as a standard duration of nivolumab for responding patients at our center; enabling us to reduce cost of treatment. It is very well tolerated; but a careful watch should be kept for immune related AEs.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Amit Rauthan.
Funding
Has not received any funding.
Disclosure
A. Rauthan: Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Eli Lilly; Advisory / Consultancy: Roche; Advisory / Consultancy: MSD; Advisory / Consultancy: Pfizer. All other authors have declared no conflicts of interest.
Resources from the same session
154P - Genetic characteristics of participants in the Australian Pancreatic Screening Study
Presenter: Krithika Murali
Session: Poster display session
Resources:
Abstract
155P - Mean Platelet Volume (MPV) is it a new prognostic marker in resectable carcinoma stomach?
Presenter: Girish M. S
Session: Poster display session
Resources:
Abstract
156P - A positive feedback between IDO1 metabolite and COL12A1 via MAPK pathway to promote gastric cancer metastasis
Presenter: Zhen Xiang
Session: Poster display session
Resources:
Abstract
157P - Lymph node ratio (LNR) a better prognostic factor after D2 gastrectomy
Presenter: Jitin Yadav
Session: Poster display session
Resources:
Abstract
158P - A clinical significance of preoperative C-reactive protein/albumin ratio in patients with extrahepatic bile duct cancer
Presenter: Kim Jinkook
Session: Poster display session
Resources:
Abstract
159P - The relation between obesity and cancer of gastrointestinal tract in Korea: The data from Statistic Korea between 2001 and 2016
Presenter: Hee Man Kim
Session: Poster display session
Resources:
Abstract
160P - Clinical outcomes of second-line chemotherapy after progression on nab-paclitaxel plus gemcitabine in patients with metastatic pancreatic adenocarcinoma
Presenter: Jooyoung Ha
Session: Poster display session
Resources:
Abstract
161P - Chitinase 3-Like 1 gene (T/C) polymorphism and serum YKL-40 in hepatocellular carcinoma
Presenter: Alshimaa Alhanafy
Session: Poster display session
Resources:
Abstract
162P - Hypofractionated radiotherapy for pulmonary metastases from hepatocellular carcinoma: Treatment response and prognostic factors affecting survival
Presenter: In Young Jo
Session: Poster display session
Resources:
Abstract
163P - Excision repair cross-complementation group 1 and 2 (ERCC1/2) Single nucleotide polymorphisms and chemotherapy treatment outcome in Cholangiocarcinoma
Presenter: Thanachai Sanlung
Session: Poster display session
Resources:
Abstract