ASCO 2018: Nivolumab for Patients with Metastatic Non-Clear Cell Renal Cell Carcinoma: A Single-Institution Experience

Chicago, IL (UroToday.com) Nivolumab alone and in combination with ipilimumab are currently FDA approved for patients with metastatic clear cell RCC (MRCC) as 2nd line therapy, and those who are treatment naïve, respectively. Variant histology RCC (VHRCC) to date have very limited therapeutic options and poor outcomes, when compared to clear cell RCC. The role nivolumab in VHRCC is unknown.

This study was a single institution retrospective analysis of best overall response rates (ORR), progression free survival (PFS) and overall survival (OS) after treatment with nivolumab in VHRCC patients. To be included in the analysis, patients had to have metastatic non-clear cell RCC or clear cell RCC with at least 20% rhabdoid differentiation. Furthermore, patients had to receive nivolumab as a single agent or in combination with other systemic therapies.

The results demonstrated a disease control rate (DCR) for the overall cohort of 60% and ORR of 17.5%. For patients receiving nivolumab in combination with other systemic therapies the DCR was 89.9% with an ORR of 44.5%. ORR in the treatment naïve patients was 50%. At a median follow-up of 24.5 months (17.7-32.6), the median PFS was 4.9 months (3.5-10.2) and the median OS was 21.1 months (7.8-NA). Median PFS and OS did not significantly differ by histology (Figure 1-3).

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The authors concluded that nivolumab demonstrated clinical activity in VHRCC patients with an ORR of 17.5% and DCR of 60%. Despite the clear limitation of this study, due to its retrospective nature, this is the best evidence to date to support the need for a randomized trial of nivolumab activity in patients with VHRCC.

Presented by: Jad Chahoud, University of Texas MD Anderson Cancer Center, Houston, TX

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, Twitter:@GoldbergHanan at the 2018 ASCO Annual Meeting - June 1-5, 2018 – Chicago, IL USA
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