Abstract 5268
Background
N is a standard of care for patients with mccRCC after failure of a TKI. Nevertheless, nearly 45% of pts had a progressive disease (PD) as best response and PFS was disappointing. In this study we sought to describe a “real-world” cohort of pts with mRCC treated with N beyond first progression to identify factors predicting a clinical benefit.
Methods
We included in a retrospective study all consecutive mRCC pts who received at least one N injection at a French single-center between 2013 and 2018. Clinical and biological data were collected prospectively. Radiological evaluations were done by CT-scan using iRECIST. Characteristics of pts who with unconfirmed PD (iuPD) were described and compared according to the continuation of N beyond iuPD or not. Pts with a clinical benefit (CB) (objective response (OR=CR+PR) or stable disease (SD)) from N post-iuPD, were compared with pts with icPD as best response (BOR) post-iuPD.
Results
109 patients were included, 84% had a clear cell histology; IMDC’s favorable, intermediate and poor prognostic groups at N initiation were 21%, 52% and 27%, respectively. After a median follow-up of 24.4 months [14.9-NA], median PFS and OS were 6.03 months [4.6-10] and 25.8 months [24.2-30.1] respectively. ORR was 18.4% (3.7% CR) and 74 pts experienced a first iuPD, including 5 clinical PD. Among the 69 radiological iUPD, 12 had new lesions (16%), 32 had progression of pre-existing lesions (43%) and 25 had both (33%). 36 pts (49%) received N beyond PD. Responses post-iuPD were 3 (4%) PR, 14 (19%) SD and 17 (23%) icPD.; they were more frequently ECOG-PS 0-1 (86% versus 47%, p = 0.0005), had better IMDC group (FAV+INT = 86% vs 53%, p = 0.01) and had higher lymphocyte count (p = 0.04). 17/18 (48%) pts had a CB with N post-iuPD, with a better OS than those without CB (31.8 months vs 24.9 months, p = 0.02). The only factor associated with the absence of CB were LDH>200 (p = 0.038).
Conclusions
We report the largest analysis of treatment with N beyond progression in a real world cohort of mRCC supporting that pseudo-progression is a rare event (4%). We show also that treatment beyond progression is very common (49%) and that LDH>200 might be the better ready-to-use predictive factor of a lack of CB.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Yann-Alexandre Vano.
Funding
Has not received any funding.
Disclosure
L. Fournier: Speaker Bureau / Expert testimony: Bayer; Speaker Bureau / Expert testimony: Novartis; Speaker Bureau / Expert testimony: Janssen; Speaker Bureau / Expert testimony: Sanofi; Research grant / Funding (institution): Invectys; Research grant / Funding (institution): Philips; Research grant / Funding (institution): Evolucare; Research grant / Funding (institution): ArianaPharma; Research grant / Funding (institution): Imagia. C. Thibault: Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: AstraZeneca; Advisory / Consultancy: BMS; Travel / Accommodation / Expenses: Roche; Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: Sanofi; Advisory / Consultancy, Travel / Accommodation / Expenses: Janssen; Advisory / Consultancy: Astellas; Advisory / Consultancy, Travel / Accommodation / Expenses: Pfizer. Y. Vano: Advisory / Consultancy, Research grant / Funding (institution): BMS; Advisory / Consultancy: Roche; Advisory / Consultancy: Ipsen; Advisory / Consultancy: Pfizer MSD; Advisory / Consultancy: Novartis; Advisory / Consultancy: Merck; Advisory / Consultancy: Janssen-Cilag; Advisory / Consultancy: Sanofi; Advisory / Consultancy: Astellas. All other authors have declared no conflicts of interest.
Resources from the same session
5007 - Functional systemic CD4 immunity is required for clinical responses to PD-L1/PD-1 blockade therapy
Presenter: Miren Zuazo
Session: Poster Display session 3
Resources:
Abstract
5760 - Landscape of PD-L1 expression status in Chinese solid tumor patients.
Presenter: Yi Zhong
Session: Poster Display session 3
Resources:
Abstract
3733 - Anti-cancer and immunomodulatory effects of cobimetinib in triple negative breast cancer
Presenter: Chun-Yu Liu
Session: Poster Display session 3
Resources:
Abstract
4426 - Differential expression of immunoregulatory molecules and highly-associated cancer genes may provide novel insights into strategic trial design for therapeutics
Presenter: Jacob Adashek
Session: Poster Display session 3
Resources:
Abstract
2752 - Insights into the Tumor Immune Microenvironment using Tissue Phenomics to Drive Cancer Immunotherapy
Presenter: Martin Groher
Session: Poster Display session 3
Resources:
Abstract
5713 - Immune competent somatic mosaic model of colorectal cancer
Presenter: Stefania Napolitano
Session: Poster Display session 3
Resources:
Abstract
1898 - Genomic correlates of response to anti-PDL1 Atezolizumab in non-small-cell lung cancer OAK and POPLAR trials
Presenter: Hari Singhal
Session: Poster Display session 3
Resources:
Abstract
3246 - Erdafitinib (erda) versus available therapies in advanced urothelial cancer: A matching adjusted indirect comparison
Presenter: Yohann Loriot
Session: Poster Display session 3
Resources:
Abstract
3311 - High level of activity of Nivolumab anti-PD-1 immunotherapy and favorable outcome in metastatic/refractory MSI-H non-colorectal cancer: Results of the MSI cohort from the French AcSé program
Presenter: Christophe Tournigand
Session: Poster Display session 3
Resources:
Abstract
2314 - TP53 and ATM Co-mutation Predicts Response to Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer
Presenter: Yu Chen
Session: Poster Display session 3
Resources:
Abstract