The authors retrospectively identified 312 patients with mRCC in the IMDC who were treated with immunotherapy (one or more lines of immunotherapy with or without a targeted agent). The overall response rate (ORR) for the cohort was 29%, including 29% among those treated as first-line treatment, 22% for second-line, 33% for third-line, and 32% for fourth-line treatment. Among patients treated with second-line immunotherapy, they were divided into favorable, intermediate, and poor risk using IMDC criteria. The corresponding median duration of treatment (DOT) rates were not reached (NR), 8.6 months, and 1.9 months, respectively (p<0.001) for these patients receiving second line treatment. With respect to patients ≥70 years of age, ORRs were 14-25% across first through – fourth line therapy, lower but comparable to patients <70 years of age. Using Cox proportional regression analysis, the association between age as a continuous variable and DOT was assessed; the hazard ratios calculated in the first- through fourth-line therapy setting ranged from 1.03 to 0.97. A possible limitation of this study is the retrospective nature and the inherent selection bias associated with these types of observational studies when assessing treatment and subsequent outcomes.
In conclusion, the authors found that the ORR for immunotherapy is consistent regardless of line of therapy. In the second line, IMDC criteria appropriately stratify patients into favorable, intermediate and poor risk groups for duration of treatment. Importantly, age does not appear to be an influential factor influencing DOT regardless of line of therapy.
Presented By: Steven Yip, University of Calgary, Calgary, AB, Canada
Co-Authors: Connor Wells, Raphael Brandao Moreira, Alex Wong, Sandy Srinivas, Benoit Beuselinck, Camillo Porta, Hao-Wen Sim, D. Scott Ernst, Brian I. Rini, Takeshi Yuasa, Naveen S. Basappa, Ravindran Kanesvaran, Lori Wood, Christina M. Canil, Anil Kapoor, Simon Yuen Fai Fu, Toni K. Choueiri, Daniel Yick Chin Heng
Written By: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre
at the 2017 ASCO Annual Meeting - June 2 - 6, 2017 – Chicago, Illinois, USA