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Do Sex-Specific Hormones Influence Outcomes With Immunotherapy for Kidney Cancer?

By: Vanessa A. Carter, BS
Posted: Monday, April 5, 2021

Martin Thurnher, PhD, of Medical University Innsbruck, Austria, and colleagues evaluated the pituitary-gonadal axis's hormones for their relation to oncologic prognosis and immunotherapy response in metastatic renal cell carcinoma. Their research indicated a difference in the modulation of sex hormones during immune checkpoint inhibition therapy for men and women—although no apparent gender-specific differences in response to treatment. Their findings were published in Cancer Immunology, Immunotherapy.

The investigators focused on 22 patients with metastatic renal cell carcinoma who were undergoing therapy with the PD-1 inhibitor nivolumab. Quantitative serum measurements of follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH ratio, testosterone, prolactin, and estradiol (E2) were performed at baseline, 6 weeks (240 mg of nivolumab every 2 weeks) or 8 weeks (480 mg of nivolumab every 4 weeks), and 12 weeks. The female patients were significantly older than the males. A total of 18 patients had clear cell histology, 3 had papillary renal cell carcinoma, and 1 had chromophobe renal cell carcinoma.

The overall response rate was 22.7%; 16.7% in the male population and 30% in the female patients. Of the female participants, two achieved a complete response, one reached a partial response, and three experienced stable disease. Of the male patients, two achieved stable disease, and four had a partial response. There appeared to be no significant gender-specific differences in therapy response.

The median duration of progression-free survival and overall survival was similar in men (6 and 20.5 months) and women (7.5 and 20.5 months). There also tended to be no significant differences between hormone ratios or levels and patient characteristics at any point in time. The E2 levels in the men increased, and FSH levels decreased during the treatment period, but neither occurred in the women. There was an apparent correlation between LH/FSH ratios and progression-free survival and response to therapy in male patients alone at 6 or 8 weeks. No other hormone was found to be correlated with progression-free or overall survival.

Disclosure: The study authors reported no conflicts of interest.



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