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ISHIDA Hideki
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Professor |
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| Article types | Original article |
| Language | English |
| Peer review | Peer reviewed |
| Title | Association between immune-related adverse events and prognosis in patients with metastatic renal cell carcinoma treated with nivolumab. |
| Journal | Formal name：Urologic oncology Abbreviation：Urol Oncol ISSN code：18732496/10781439 |
| Domestic / Foregin | Foregin |
| Volume, Issue, Page | 37(6),pp.355.e21-355.e29 |
| Author and coauthor | ISHIHARA Hiroki†*, TAKAGI Toshio, KONDO Tsunenori, MUROMIYA Chie, TACHIBANA Hidekazu, FUKUDA Hironori, YOSHIDA Kazuhiko, IIZUKA Junpei, KOBAYASHI Hirohito, OKUMI Masayoshi, ISHIDA Hideki, TANABE Kazunari |
| Publication date | 2019/06 |
| Summary | OBJECTIVES:Immune-related adverse events (irAEs) develop in a subset of patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors. The relationship between presence of irAEs and prognosis in these patients remains unknown. Thus, we evaluated the prognostic impact of irAEs caused by nivolumab therapy in mRCC patients who had received prior molecular-targeted therapies.METHODS:We retrospectively evaluated 47 patients with mRCC who were treated with nivolumab after receiving at least 1 molecular-targeted therapy. The irAEs assessed in this study included cutaneous, gastrointestinal, endocrine, pulmonary, hepatobiliary, renal, and other (rheumatic disease and pancreatitis) manifestations. The grade of irAEs was defined based on the Common Terminology Criteria for Adverse Events version 4.0.RESULTS:In total, 23/47 patients (48.9%) experienced 29 irAEs. The most frequent irAE was rash/pruritus (12/23, 52.2%). The median progression-free survival (PFS) and overall survival after the initiation of nivolumab therapy were significantly longer in patients with irAEs than in those without irAEs (PFS: 13.1 vs. 4.87 months, P < 0.0001; overall survival: 26.0 vs. not reached, P = 0.0072). The multivariate analysis of PFS showed that irAE development was an independent prognostic factor (hazard ratio: 0.25, P = 0.0009). Additionally, the 2-cycle landmark analysis showed that PFS was significantly longer in patients with irAEs than in those without irAEs (median: not reached vs. 6.28 months, P = 0.0279).CONCLUSIONS:This retrospective study revealed a significant association between nivolumab-associated irAEs and prognosis in previously treated mRCC. Further prospective studies are necessary to confirm our findings. |
| DOI | 10.1016/j.urolonc.2019.03.003 |
| PMID | 30935847 |