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Immune-Related Adverse Events With Nivolumab: Predicting Outcomes in Kidney Cancer

By: Susan Reckling
Posted: Wednesday, June 26, 2019

In patients with previously treated metastatic renal cell carcinoma, development of immune-related adverse events during therapy with the immune checkpoint inhibitor nivolumab was “positively and significantly” associated with oncologic outcomes, according to the results of a retrospective study. In fact, these outcomes included both tumor response and survival. These findings were published by Hiroki Ishihara, MD, of Tokyo Women’s Medical University, and colleagues in Urologic Oncology: Seminars and Original Investigations.

“We believe that [the] presence of [immune-related adverse events] has the potential to be an effective surrogate and predictive marker of survival in nivolumab therapy of [metastatic renal cell carcinoma],” the investigators proposed. “However, further prospective studies are necessary to confirm our findings.”

This study focused on 47 patients with metastatic renal cell carcinoma who received nivolumab after at least one molecularly targeted therapy. Among the manifestations assessed were cutaneous, gastrointestinal, endocrine, pulmonary, hepatobiliary, and renal.

Nearly half (48.9%) of the study patients experienced a total of 29 immune-related adverse events, with the most common being rash/pruritus (52.2%). In patients who developed these adverse events compared with those who did not, median progression-free and overall survival were significantly longer (13.1 vs. 4.87 months and 26.0 months vs. not reached; P = .0072). In addition, the development of immune-related adverse events was found to be an independent prognostic factor (hazard ratio = 0.25), in a multivariate analysis. Finally, a significant association between this type of adverse event and progression-free survival was observed during the 2-cycle landmark analysis.

Disclosure: One author received honoraria from Ono Pharmaceutical, and all other authors reported no conflicts of interest.

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