Abstract 240P
Background
The efficacy of first-line combination immuno-oncology therapy (IO) with ipilimumab plus nivolumab in metastatic renal cell carcinoma was demonstrated in the international phase III randomized CheckMate-214 trial. We also realized that the prognosis of Inter/Poor risk metastatic renal cancer could be extended in real clinical practice.
Methods
At Juntendo Univ. Hosp., Ipilimumab plus Nivolumab was used as first-line combination therapy for total 30 patients, including 27 patients with real-world Inter/Poor risk metastatic renal cell carcinoma from Jan/2019 to Aug/2023 and 3 patients enrolled in the international phase III study CheckMate-214. Efficacy in overall survival and safety, mainly immune-related adverse events(irAE), were retrospectively analyzed.
Results
Median age was 63 years (27-79), 37% (11/30) had prior nephrectomy. The most common metastatic lesions were lung (60%), bone (47%), and lymph node (37%). Three cases of hemodialysis were also included. The IMDC risk classification was Favor: Inter: Poor =2: 18: 10 cases. Total 80% (24/30) of cases were able to complete 4 cycles of ipilimumab. The average duration of IO treatment was 15.8 months (2-63). And the average duration of response was 27.3 months (2-92). During the mean follow-up period of 26.5 months (2-94), 6 cases died from cancer and 2 deaths from other causes. Among the cancer death cases, 4 of 6 cases were non-clear cell RCC. Deferred cytoreductive nephrectomy (DCN) could be performed in 2 cases in which metastatic lesions were controlled by IO-combo therapy. DCN was also performed in one patient withdrawn due to irAE, and surgical complete response (CR) was obtained. A total of 23% (7/30) had irAEs that forced IO administration to be discontinued. For irAEs of endocrine disorders, such as adrenal insufficiency and diabetes type 1, IO treatment could be continued with appropriate hormone replacement.
Conclusions
IO-Combo treatment for metastatic RCC was performed effectively and safely in Japanese patients. Surgical CR may be achieved with DCN after IO combination therapy even in poor-risk patients, but there is a possibility that Ipilimumab plus Nivolumab treatment has weak efficacy for non-clear cell RCC.
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.
Resources from the same session
122P - Distinct transcriptomic immune profiling and clinicopathological features of cribriform morphology in colorectal adenocarcinomas
Presenter: Abdelhakim Khellaf
Session: Poster Display
Resources:
Abstract
123P - Spatial molecular profiling identifies FGF20 upregulation on cancer-associated fibroblast and FGFR2-PI3K/Akt activation in tumor cells of sporadic early-onset colon cancer
Presenter: Dave Hoon
Session: Poster Display
Resources:
Abstract
124P - Characteristics, prognosis and therapeutic effects of non-V600 BRAF mutated colorectal cancer
Presenter: Lalida Arsa
Session: Poster Display
Resources:
Abstract
125P - Final results of APOLLON-11 and SOYUZ-APOLLON study: Multicentre prospective observational post-authorization study of bevacizumab biosimilar in patients with metastatic colorectal cancer in real-world practice
Presenter: Alexey Tryakin
Session: Poster Display
Resources:
Abstract
126P - From tumor height (TH) to tumor regression grade (TRG) in locally advanced rectal cancers (LARC) during total neadjuvant therapy (TNT): A retrospective analysis
Presenter: Valeria Pusceddu
Session: Poster Display
Resources:
Abstract
127P - A meta-analysis of efficacy and safety from head-to-head first-line (1L) trials of epidermal growth factor receptor inhibitors (EGFRIs) versus bevacizumab in combination with chemotherapy (CT) doublets in patients with RAS wild-type (WT) metastatic colorectal cancer (mCRC) by sidedness
Presenter: Takayuki Yoshino
Session: Poster Display
Resources:
Abstract
128TiP - A phase II study of cadonilimab + FOLFOXIRI and bevacizumab as initial therapy for unresectable proficient mismatch repair/microsatellite stable (pMMR/MSS) metastatic colorectal cancer (mCRC)
Presenter: Rongbo Lin
Session: Poster Display
Resources:
Abstract
140P - Prevalence of claudin-18 isoform 2 (CLDN18.2) positivity in locally advanced (LA) unresectable or metastatic gastric or gastroesophageal junction (mg/GEJ) adenocarcinoma in patients (pts) in the Asia region: Phase III SPOTLIGHT and GLOW studies
Presenter: Hoo Hwoei Fen Soo
Session: Poster Display
Resources:
Abstract
141P - Early phase trials outcomes in refractory upper GI cancers: A 10-year analysis from the SCRI UK phase I unit
Presenter: Antonella Cammarota
Session: Poster Display
Resources:
Abstract
142P - The survival impact of the addition of durvalumab to cisplatin/gemcitabine in advanced biliary tract cancer: A real-world, retrospective, multicentric study
Presenter: Silvia Foti
Session: Poster Display
Resources:
Abstract