Study Finds Limited Activity With Immunotherapy for Brain Metastases From Kidney Cancer
Posted: Monday, July 29, 2019
Results from the GETUG-AFU 26 NIVOREN trial indicate that for patients with brain metastases resulting from metastatic clear cell renal cell carcinoma, nivolumab has limited activity. Ronan Flippot, MD, of Gustave Roussy, Université Paris-Saclay, Villejuif, France, and colleagues suggest that this patient population may benefit more from other therapeutic alternatives.
“These data highlight the need to pursue dedicated clinical trials in this population and advocate for the evaluation of combination strategies using systemic and focal brain therapies,” the authors observed. Their study findings were published in the Journal of Clinical Oncology.
This phase II trial (ClinicalTrials.gov identifier NCT03013335) involved patients diagnosed with metastatic clear cell recall cell carcinoma who previously failed to respond to VEGF-directed therapies. The 73 patients with brain metastases were categorized into two cohorts. Cohort A (39 patients) consisted of those with previously untreated brain metastases, and cohort B (34 patients) included those who underwent prior therapy for their brain metastases.
For patients in cohort A, just 12% exhibited an intracranial response rate to nivolumab. The median intracranial progression-free survival in cohort A was 2.7 months, compared with 4.8 months for patients in cohort B (adjusted hazard ratio = 2.04). Patients in cohort A had an overall survival rate of 67% at 12 months, whereas for those in cohort B, it was 59% over the same period. A majority of patients in cohort A required subsequent focal brain therapy (72%). The authors noted that nivolumab was well tolerated by both cohorts, with unexpected toxicity.
“The identification of patients with extracranial partial response but intracranial progressive disease pinpoints the importance of concomitant brain and body evaluation in patients with brain metastases from [clear cell renal cell carcinoma],” the investigators observed.
Disclosure: The study authors’ disclosure information may be found at ascopubs.org.