Ipilimumab Plus Nivolumab Therapy for Renal Cell Carcinoma With Brain Metastasis
Posted: Wednesday, December 1, 2021
The combination of the CTLA-4 inhibitor ipilimumab plus the PD-1 inhibitor nivolumab has shown efficacy in the treatment of metastatic renal cell carcinoma with brain metastasis in patients who received central nervous system (CNS)-directed local therapy, according to Tian Zhang, MD, of Duke University School of Medicine, and colleagues. These findings were published in the Journal for ImmunoTherapy of Cancer.
“Further investigation [of this combination therapy] is warranted in this population given exclusion from prior clinical trials,” the authors concluded.
In this retrospective study of patients with metastatic renal cell carcinoma who were treated with the combination of ipilimumab and nivolumab between 2016 and 2020, a cohort of 19 patients with brain metastasis at the beginning of treatment were identified. A total of 16% had favorable-risk disease, whereas 58% and 26% had intermediate- and poor-risk disease, respectively. Of note, most patients were White (n = 17, 89%) and male (n = 14, 74%). Almost all patients (84%) received local CNS therapy, including radiation therapy with or without surgery before the initiation of the immunotherapy combination.
The median progression-free survival was 7.6 months, and the 12-month progression-free survival was 26%. The overall survival rates at 12 and 24 months were 74% and 68%, respectively; however, median overall survival was not reached. The objective response rate was 44%, with 50% of patients treated in the second line or beyond showing a partial response.
Immune-related adverse events occurred in 63% of patients, with 16% discontinuing treatment as a result. Another 42% discontinued treatment due to disease progression.
Disclosure: The study authors’ disclosure information can be found at jitc.bmj.com.