RCC: immunotherapy rechallenge feasible in some patients

  • Abou Alaiwi S & al.
  • J Immunother Cancer
  • 1 Feb 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • 50% of patients with metastatic renal cell carcinoma (RCC) experience immune-related adverse events (irAEs) with immunotherapy rechallenge after discontinuation for toxicity.
  • However, these irAEs are manageable, with no grade 4/5 toxicity or treatment-related deaths.

Why this matters

  • These findings can guide clinicians on retreatment with immunotherapy.
  • Further research is needed to identify patients likely to benefit from rechallenge.

Study design

  • 80 patients with metastatic renal cell carcinoma treated who developed irAEs with immune-checkpoint inhibitors.
  • 36 patients were rechallenged with immunotherapy, and 44 were permanently discontinued.
  • Funding: None disclosed.

Key results

  • Fewer retreatment patients required corticosteroids (55.6% vs 84.1%; P=.007) and hospitalizations (33.3% vs 65.9%; P=.007) for irAE management vs discontinued patients.
  • 50% of retreated patients experienced subsequent irAEs (12 new and 6 recurrent; grade 3 events, 7; drug interruptions, 13).
  • All irAEs with retreatment were grade ≤3 with no grade 4/5 events.
  • Median time to irAE recurrence after retreatment was 2.8 months.
  • In the discontinued vs retreatment groups:
    • Overall response rate was 43% (95% CI, 28%-59%) vs 44% (28%-62%).
    • 2-year OS was 66% (48%-79%) vs 76% (55%-88%).

Limitations

  • Retrospective design.