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
221P - Comparative analysis of first-line immune checkpoint inhibitor versus carboplatin-based chemotherapy for cisplatin-ineligible metastatic urothelial carcinoma: A multicenter, retrospective real-world evidence
Presenter: Hsiang‐Lan Lai
Session: Poster display session
Resources:
Abstract
222P - Does tumor grade really improve the prognostic ability of the staging system for men with penile cancer: A SEER database analysis
Presenter: Ravi Kanodia
Session: Poster display session
Resources:
Abstract
223TiP - EV-301: A phase III trial in progress evaluating enfortumab vedotin versus chemotherapy in patients with locally advanced or metastatic urothelial carcinoma
Presenter: Daniel Petrylak
Session: Poster display session
Resources:
Abstract
230P - Olaparib maintenance therapy in patients (pts) with a BRCA1 and/or BRCA2 mutation (BRCAm) and newly diagnosed advanced ovarian cancer (OC): SOLO1 China cohort
Presenter: Lingying Wu
Session: Poster display session
Resources:
Abstract
231P - Cost-effectiveness of olaparib vs routine surveillance in the maintenance setting for patients with BRCA-mutated advanced ovarian cancer after response to first-line platinum-based chemotherapy in Singapore
Presenter: David SP Tan
Session: Poster display session
Resources:
Abstract
233P - Incorporation of correlative studies in ovarian cancers in the era of precision medicine: Assessment of accountability and utility
Presenter: Nadia Hitchen
Session: Poster display session
Resources:
Abstract
234P - Implementation of mainstream BRCA testing in epithelial ovarian cancer in a tertiary centre
Presenter: Edbert Wong
Session: Poster display session
Resources:
Abstract
235P - The efficacy of radiation therapy in ovarian carcinoma: A propensity score analysis of a population-based study
Presenter: Jian-Guo Zhou
Session: Poster display session
Resources:
Abstract
236P - Front-line maintenance therapy for platinum-sensitive ovarian cancer: What’s next PARP inhibitors?
Presenter: Han Gong
Session: Poster display session
Resources:
Abstract
237P - PARP inhibitor in platinum resistant ovarian cancer: Single center real world experience
Presenter: Saphalta Baghmar
Session: Poster display session
Resources:
Abstract