Metastases from renal cell carcinoma develop in various organs. However, the breadth of discrepancy in response to immune checkpoint inhibitors across tumor sites within the same individual remains unclear.
We reviewed 50 patients with metastatic renal cell carcinoma who had target lesions at multiple sites and received nivolumab monotherapy (n = 36) or nivolumab plus ipilimumab (n = 14). When the best overall response in tumor burden increased at one site but decreased at other sites, the response was defined as a dissociated response. The response was evaluated according to the Response Evaluation Criteria in Solid Tumors 1.1, and patients who met the definition of dissociated response were categorized as dissociated response. The rate of dissociated response and prognosis were evaluated.
Eight of 36 (22%) and 4 of 14 (29%) patients treated with nivolumab and nivolumab plus ipilimumab were categorized as having dissociated response, respectively. The median overall survival of the patients treated with nivolumab was 20.2 months for those with a partial response, 6.8 months for those with stable disease, and 13.2 months for those with progressive disease, while dissociated response was not reached. There was no significant difference in the median overall survival between patients categorized as having progressive disease and those with dissociates response (P = 0.224).
A certain proportion of patients with metastatic renal cell carcinoma show dissociated response when treated with immune checkpoint inhibitors. The prognosis of patients with dissociated response and progressive disease was not shown to be significantly different.
Japanese journal of clinical oncology. 2022 Sep 11 [Epub ahead of print]
Takahito Negishi, Tohru Nakagawa, Naotaka Nishiyama, Hiroshi Kitamura, Eijiro Okajima, Nobuki Furubayashi, Yoshifumi Hori, Kentarou Kuroiwa, Yuhyon Son, Narihito Seki, Toshihisa Tomoda, Motonobu Nakamura
Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan., Department of Urology, Teikyo University School of Medicine, Tokyo, Japan., Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research University of Toyama, Toyama, Japan., Department of Urology, Nara City Hospital, Nara, Japan., Department of Urology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan., Department of Urology, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan., Department of Urology, Oita Prefectural Hospital, Oita, Japan.