Back to Search Start Over

Effect of Treatment of Residual Disease After Immunotherapy-Based Combinations on Complete Response Rate of Patients With Metastatic Renal Cell Carcinomas.

Authors :
Moinard-Butot F
Oriel M
Tricard T
Cazzato RL
Pierard L
Gaillard V
Werle P
Lindner V
Martin S
Schuster C
Roy C
Burgy M
Anthony A
Bigot C
Boudier P
Fritsch A
Olland A
Malouf G
Lang H
Barthélémy P
Source :
Clinical genitourinary cancer [Clin Genitourin Cancer] 2024 Oct; Vol. 22 (5), pp. 102134. Date of Electronic Publication: 2024 Jun 05.
Publication Year :
2024

Abstract

Introduction: Immune checkpoint inhibitor (ICI)-based combinations have revolutionized the management of first-line metastatic renal cell carcinoma (mRCC) by improving patient survival. Large phase 3 randomized trials assessing ICI-based combinations have reported complete response (CR) rates of 10% to 18% in the first-line setting. However, there is a scarcity of data about the effect of treatment of residual disease regarding CR rates improvement.<br />Materials and Methods: We included retrospectively all consecutive mRCC patients treated in first-line setting at the Institut de Cancérologie Strasbourg Europe with an ICI-based combination involving ICI or TKI, either alone or with added local treatment of residual disease. Patients were characterized according to IMDC risk. Radiologic response was defined according to RECIST v1.1.<br />Results: We enrolled 80 mRCC patients treated with ICI-based combinations between May 2015 and May 2022. The median age was 63 years. Regarding IMDC risk, there were 12 favourable (15%), 50 intermediate (63%), and 18 poor-risk (22%) patients. Forty-seven patients (59%) received ICI + ICI, 24 (30%) received ICI + TKI, and 9 (11%) received another ICI-based therapy. In total, 8 achieved CR (10%), 36 patients (45%) achieved partial response, 23 (29%) achieved stable disease and 12 achieved progressive disease (15%) as the best response with systemic therapy alone. By adding local treatment of residual disease, 11 additional patients (14%) achieved radiological NED. Residual disease resected sites included kidney (n = 6), lymph nodes (n = 5), lung metastases (n = 2) and liver metastases (n = 1).<br />Conclusions: The resection of residual disease after first-line ICI-based therapy is associated with improved CR rate (CR + NED) in patients with mRCC. These results need to be validated in prospective trial.<br />Patient Summary: In recent years, the advent of immunotherapy has radically changed the management of patients with metastatic kidney cancer. Approximately 10% to 18% of these patients using immune checkpoint inhibitor (ICI)-based combinations no longer have detectable disease on CT scans (complete response). There are currently few data on the use of treatment of residual disease to increase the number of patients in complete response. In this retrospective study, the complete response rate with ICI-based treatment was 10%. When local treatment was added, the number of patients with a complete response increased to 24%. This strategy could increase the number of patients with a prolonged complete response in the future.<br />Competing Interests: Disclosures Fabien Moinard-Butot certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: F. Moinard-Butot has served in advisory roles for BMS. T. Tricard has received travel and accommodation expenses from Janssen. RL. Cazzato has received travel and accommodation expenses from Medtronic, Ipsen and QUANTUM SURGICAL. L. Pierard has received travel and accommodation expenses from Ipsen, Johnson & Johnson, Pfizer, Eli lilly and company, MUNDI PHARMA. V. Lindner reports speaker services for AstraZeneca, Ipsen; and has received travel and accommodation expenses from Ipsen, MSD and Pfizer. S. Martin has served in advisory roles for BMS. M. Burgy has served in advisory roles for Lilly; reports speaker services for BMS and MSD; has received travel and accommodation expenses from Pfizer, Ipsen and MUNDIPHARMA. G. Malouf has served in advisory roles for BMS, MSD and Ipsen; has received travel and accommodation expenses from MSD, Ipsen and BMS. H. Lang reports speaker services for Johnson & Johnson, Astellas pharma. P. Barthélémy has served in advisory roles for Amgen, Astellas, Bayer, BMS, Ipsen, Janssen Cilag, Merck, MSD, Novartis, Gilead Sciences and Pfizer and reports speaker services for AstraZeneca and Seagen. M. Oriel, V. Gaillard, P. Werle, C. Schuster, C. Roy, A. Anthony, C. Bigot, P. Boudier and A. Fritsch have any conflicts of interest.<br /> (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1938-0682
Volume :
22
Issue :
5
Database :
MEDLINE
Journal :
Clinical genitourinary cancer
Publication Type :
Academic Journal
Accession number :
38909529
Full Text :
https://doi.org/10.1016/j.clgc.2024.102134