The prognostic impact of Immune Related Adverse Events in Metastatic Renal Cell Carcinoma in Patients Treated with Nivolumab: Real World Multi-Institutional Retrospective Study
There has long been speculation as well as small case series publications regarding the correlation between immune related adverse events and immunotherapy response in a variety of tumors. In this study, investigators reported on a retrospective review of 160 patients with advanced renal cell carcinoma who were treated with nivolumab. Patient’s charts were reviewed between September 2016 and July 2019. Immune related adverse events were defined as patients who had adverse events during therapy, which could be attributed to immunotherapy. Immunosuppressive therapy use was not an inclusion criteria.
Of the 160 patient screened, 47 met the criteria of developing an immune related adverse event. In these patients, the objective response rate was 38.8% and the disease control rate was 77.6%. These were significantly higher when compared to patients who did not experience immune-related adverse events, P = 0.012 and P < 0.001, respectively. The incidence of immune-related adverse events was significantly associated with increasing progression free survival, hazard ratio 0.4867 P = 0.0006. There is also a correlation with overall survival, hazard ratio of 0.526 with P = 0.0252.
The authors also noted that progression free survival and overall survival were similar in patients who discontinued treatment as a result of immune related adverse events and those who continued with therapy, P = 0.36 and p = 0.35 respectively.
The authors concluded, “development of immune related adverse events strongly correlates with clinical benefit for metastatic renal cell carcinoma patients receiving nivolumab monotherapy in the real world setting”