ISHIDA Hideki    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Comparable efficacy and safety between second-line and later-line nivolumab therapy for metastatic renal cell carcinoma.
Journal	Formal name：International journal of clinical oncology Abbreviation：Int J Clin Oncol ISSN code：14377772/13419625
Domestic / Foregin	Foregin
Volume, Issue, Page	25(4),pp.705-712
Author and coauthor	ISHIHARA Hiroki†*, TAKAGI Toshio, KONDO Tsunenori, FUKUDA Hironori, TACHIBANA Hidekazu, YOSHIDA Kazuhiko, IIZUKA Junpei, KOBAYASHI Hirohito, OKUMI Masayoshi, ISHIDA Hideki, TANABE Kazunari
Publication date	2020/04
Summary	BACKGROUND:The aim of this study was to compare the efficacy and safety of nivolumab as second-line and later-line (third-line or thereafter) therapy in metastatic renal cell carcinoma (mRCC).METHODS:Sixty-seven patients who received nivolumab after the failure of at least one molecular-targeted therapy were evaluated. The patients were divided into two groups based on the line of nivolumab: second-line and later-line groups. Efficacy was assessed using progression-free survival and overall survival (OS) after nivolumab initiation, and objective response rate. Safety was assessed using the incidence of immune-related adverse events. These outcomes were compared between the second-line and later-line groups.RESULTS:Forty-two patients (62.7%) received nivolumab as second-line therapy. There was no significant difference in the progression-free survival (median: 5.06 vs. 6.28 months, p = 0.691) or objective response rate (35.7% vs. 32.0%, p = 0.757) between the second-line and later-line groups. The OS tended to be longer in the second-line group (not reached vs. 26.0 months, p = 0.118), and the rate of patients who received subsequent therapy after nivolumab failure was significantly higher in the second-line group (90.9% vs. 55.0%, p = 0.0025). There was no difference in the incidences of immune-related adverse events between the second-line and later-line groups (any grade: 54.8% vs. 48.0%, p = 0.592; grade ≥ 3: 19.1% vs. 20.0%, p = 0.924).CONCLUSIONS:The efficacy of nivolumab did not deteriorate and the tolerability was also maintained even in later-line therapy. However, a tendency of longer OS and a higher chance of subsequent therapy after nivolumab failure were observed with nivolumab as second-line therapy.
DOI	10.1007/s10147-019-01605-9
PMID	31858306