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Is Immunotherapy Combination Effective as Salvage Treatment in Metastatic Renal Cell Carcinoma?

By: Vanessa A. Carter, BS
Posted: Friday, January 1, 2021

The use of ipilimumab combined with nivolumab in the salvage treatment of metastatic renal cell carcinoma has been shown to demonstrate antitumor activity with “acceptable” toxicity in patients who received prior checkpoint inhibition treatment, according to Brian I. Rini, MD, of Cleveland Clinic Taussig Cancer Institute, and colleagues. However, additional study is needed to determine the durability of response and the benefit/risk ratio. The results of this study were published in the Journal of Clinical Oncology.

The researchers enrolled a total of 45 patients with metastatic renal cell carcinoma who had undergone prior anti–PD-1 pathway–targeted therapy. Participants had any histology and received at least one dose of immune checkpoint inhibitor therapy in the past. Salvage ipilimumab and nivolumab were administered after immune checkpoint inhibitor treatment was completed. The median age of patients was 62 years, and the median number of prior therapies was three. All patients had more than one site of metastasis.

The objective response rate at the median follow-up of 12 months was 20%. The median progression-free survival and duration of response were 4 and 7 months, respectively. The best objective response was partial response in 23% of participants; 67% of them had an ongoing response. The median immune-related adverse events occurred in 64% of patients, with 13% of them being at least grade 3.

Adverse events such as diarrhea, skin rash, hepatotoxicity, and pneumonitis affected 16%, 13%, 9%, and 7% of individuals, respectively. Arthralgia occurred in 7% of patients, and fatigue, thyroiditis, and colitis each affected 4%. Dry mouth, enteritis, polymyalgia-like symptoms, nephritis, and thrombocytopenia all occurred in 2% of patients. The ipilimumab and nivolumab induction phase was carried out in 51% of patients without interruption. Treatment delay occurred in 9% of patients, and 13% halted treatment due to immune-related adverse events. Treatment interruption affected 9% of patients because of nontreatment-related adverse events.

Disclosure: For full disclosures of study authors, visit

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