Nivolumab treatment beyond progression for metastatic renal cell carcinoma: New role of metastasectomy in the immune checkpoint inhibitor era?

Ishihara, Hiroki; Takagi, Toshio; Kondo, Tsunenori; Fukuda, Hironori; Yoshida, Kazuhiko; Tanabe, Kazunari

doi:10.1111/iju.14269

Cited by 2 publications

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“…Furthermore, nivolumab TBP could be effective in selected patients (Fig. ), as reported in previous studies 30,31 . We also observed a tendency for improved OS in the nivolumab group compared with that of the mTT group in an exclusive population that received subsequent therapy and nivolumab TBP (Fig.…”

Section: Discussionsupporting

confidence: 86%

Efficacy of nivolumab versus molecular‐targeted therapy as second‐line therapy for metastatic renal cell carcinoma: Real‐world data from two Japanese institutions

et al. 2020

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ObjectivesTo compare the efficacy of nivolumab with that of molecular‐targeted therapy as a second‐line therapy for metastatic renal cell carcinoma using real‐world data.MethodsWe retrospectively evaluated patients who received nivolumab or molecular‐targeted therapy after the failure of first‐line molecular‐targeted therapy between January 2008 and December 2019 at two Japanese institutions. Progression‐free survival and overall survival after the initiation of second‐line therapy were calculated using the Kaplan‐Meier method and compared using the log‐rank test. Objective response rate was assessed based on the Response Evaluation Criteria in Solid Tumors version 1.1.ResultsAmong 159 patients, 43 (27%) and 116 (73%) patients received nivolumab and molecular‐targeted therapy as second‐line therapy, respectively. During follow up (median 11.1 months), 129 (81%) and 98 (62%) patients had disease progression and died, respectively. Progression‐free survival was comparable between the two treatments (median 5.06 vs 5.95 months, P = 0.881), whereas overall survival was significantly longer with nivolumab than with molecular‐targeted therapy (not reached vs 13.0 months, P = 0.0008). Multivariate analysis further showed that nivolumab therapy was an independent favorable factor for overall survival (hazard ratio 0.33, P = 0.0007). In 151 patients with eligible radiographic data, the objective response rate was significantly higher in nivolumab than in molecular‐targeted therapy (n = 14/41 [34%] vs n = 20/110 [18%], P = 0.0485).ConclusionsReal‐world data analysis suggests superior efficacy of nivolumab over molecular‐targeted therapy as second‐line therapy for metastatic renal cell carcinoma.

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Section: Discussionsupporting

confidence: 86%

Efficacy of nivolumab versus molecular‐targeted therapy as second‐line therapy for metastatic renal cell carcinoma: Real‐world data from two Japanese institutions

et al. 2020

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“…I believe that the potential benefits of metastasectomy are as follows: (i) a patient can discontinue his or her medical therapy at least for a certain period until a recurrence is diagnosed and (ii) when most other metastatic lesions shrink but only one or two lesions grow (mixed response), surgical removal of only the growing lesions can achieve surgical CR. Others also described the potential benefit of the surgical removal of the growing tumor 5 . In this case presented by Hagimoto et al ., the medical therapy had already been discontinued before surgical removal.…”

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confidence: 76%

Editorial comment from Dr Yuasa to Pathological complete response after nivolumab therapy following angiogenesis inhibitors in a patient with metastatic renal cell carcinoma

Nivolumab treatment beyond progression for metastatic renal cell carcinoma: New role of metastasectomy in the immune checkpoint inhibitor era?

Cited by 2 publications

References 7 publications

Efficacy of nivolumab versus molecular‐targeted therapy as second‐line therapy for metastatic renal cell carcinoma: Real‐world data from two Japanese institutions

Efficacy of nivolumab versus molecular‐targeted therapy as second‐line therapy for metastatic renal cell carcinoma: Real‐world data from two Japanese institutions

Editorial comment from Dr Yuasa to Pathological complete response after nivolumab therapy following angiogenesis inhibitors in a patient with metastatic renal cell carcinoma

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