Significance of timing of therapeutic line on effectiveness of nivolumab for metastatic renal cell carcinoma

• Published in: Current urology Vol. 17; no. 1; pp. 52 - 57
• Main Authors: Teishima, Jun, Murata, Daiki, Yukihiro, Kazuma, Sekino, Yohei, Inoue, Shogo, Hayashi, Tetsutaro, Mita, Koji, Hasegawa, Yasuhisa, Kato, Masao, Kajiwara, Mitsuru, Shigeta, Masanobu, Maruyama, Satoshi, Moriyama, Hiroyuki, Fujiwara, Seiji, Matsubara, Akio
• Format: Journal Article
• Language: English
• Published: Lippincott Williams & Wilkins 01-03-2023; Wolters Kluwer Health
• Subjects: Special Topic: Advances in Renal Cell Carcinoma Therapy: Original
• ISSN: 1661-7649; 1661-7657
• DOI: 10.1097/CU9.0000000000000105

Abstract Objectives This study aimed to clarify the significance of therapeutic timing on the effectiveness of nivolumab for treating metastatic renal cell carcinoma. Marterials and methods Fifty-eight patients with metastatic renal cell carcinoma treated with nivolumab monotherapy were retrospectively studied. Patients who were treated with nivolumab as second-line therapy were included in the second-line group, while the others were included in the later-line group. The clinicopathological characteristics, effects of nivolumab, and prognoses of these groups were compared. Results Twenty and thirty-eight patients were included in the second-line and later-line groups, respectively. There were no significant differences in the distribution of International Metastatic Renal Cell Carcinoma Database Consotium risk and other clinicopathological characteristics between the 2 groups. The proportion of patients whose objective best response was progressive disease in the second-line group was significantly lower than that in the later-line group (15% vs. 50%, p = 0.0090). The 50% progression-free survival with nivolumab in the second-line group was significantly better than that in the later-line group (not reached and 5 months, p = 0.0018). Multivariate analysis showed that the second-line setting was an independent predictive factor for better progression-free survival ( p = 0.0028, hazard ratio = 0.108). The 50% overall survival after starting nivolumab in the second-line and later-line groups was not reached and 27.8 months, respectively ( p = 0.2652). Conclusions The therapeutic efficacy of nivolumab as second-line therapy is expected to be better than that of later therapy.