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
314P - An EGF motif of Del1 inhibits efficient angiogenesis and suppresses tumour growth in vivo
Presenter: Hisataka Kitano
Session: Poster display session
Resources:
Abstract
315P - Inhibition of JAK1 sensitizes human head and neck cancer cells to cetuximab
Presenter: James Bonner
Session: Poster display session
Resources:
Abstract
316TiP - Neoadjuvant and adjuvant pembrolizumab (pembro) plus standard of care (SOC) in patients (pts) with resectable locally advanced (LA) head and neck squamous cell carcinoma (HNSCC): The phase III KEYNOTE-689 study
Presenter: Ezra Cohen
Session: Poster display session
Resources:
Abstract
322P - Three-year overall survival update from the PACIFIC trial
Presenter: Yi-Long Wu
Session: Poster display session
Resources:
Abstract
323P - Novel tumour mutation score versus tumour mutation burden in predicting survival after immunotherapy in pan-cancer from MSK-IMPACT cohort
Presenter: Yuan Li
Session: Poster display session
Resources:
Abstract
324P - A novel anti-PD-1 antibody HLX10 study led to the initiation of combination immunotherapy
Presenter: Tsu Yi Chao
Session: Poster display session
Resources:
Abstract
325P - Association between immune-related adverse events and efficacy of immune checkpoint inhibitors in patients with advanced hepatocellular carcinoma
Presenter: Lawrence Wong
Session: Poster display session
Resources:
Abstract
326P - Autologous V gamma 9 V delta 2 T cell therapy to target Epstein Barr Virus (EBV)-related malignancies
Presenter: Esdy Rozali
Session: Poster display session
Resources:
Abstract
327P - Neoantigen profile of hepatocellular carcinoma reveals its correlation with tumour progression and clonal evolution
Presenter: Xiaolong Liu
Session: Poster display session
Resources:
Abstract
328P - A retrospective analysis of patients with non-small cell lung cancer who developed drug-induced lung disorder by immune checkpoint inhibitors
Presenter: Fumiko Hayashi
Session: Poster display session
Resources:
Abstract