Immune Checkpoint Inhibitors May Improve Survival Among Patients With Advanced Non-Clear Cell Renal Cell Carcinoma

According to a recent analysis, immune checkpoint inhibitor-based treatments in the first-line setting appear to be associated with improved overall survival when compared to vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) inhibitor therapies for patients with advanced non-clear cell renal cell carcinoma.

In this analysis, 1145 patients with metastatic non-clear cell renal cell carcinoma were included and classified into one of 3 groups based on the first-line therapy received: immune checkpoint inhibitor based therapy as a monotherapy or in combination (10.7%), VEGF inhibitor monotherapy (74.3%), or mTOR inhibitor monotherapy (15%). The primary outcome was overall survival. Secondary outcomes were time to treatment failure and objective response rate.

In the group of patients that received immune checkpoint inhibitor therapies, the median overall survival was 28.6 months, compared to 16.4 months in the VEGF group, and 12.2 months in the mTOR group. The median time to treatment failure was 6.9 months in the immune checkpoint inhibitor group, compared to 5.0 months and 3.9 months in VEGF and mTOR groups, respectively. In those patients treated with immune checkpoint inhibitors, the objective response rate was 27.2%, compared to 14.5% and 9% in the VEGF and mTOR groups, respectively. After adjusting for International Metastatic RCC Database Consortium risk group, histological subtype, and age, the hazard ration for overall survival was 0.57 (95% confidence interval 0.45 to 0.78, p < 0.0001) for the immune checkpoint inhibitor versus VEGF and 0.50 (95% confidence interval 0.36 to 0.71, p < 0.0001) for immune checkpoint inhibitor vs mTOR.

The study authors noted that “these results should be confirmed in prospective randomised trials.”

Source:

Graham J, Wells JC, Dudani S. Outcomes of patients with advanced non-clear cell renal cell carcinoma treated with first-line immune checkpoint inhibitor therapy. Eur J Cancer. Published online June 16, 2022. doi:10.1016/j.ejca.2022.05.002