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Cited by 48Cancer Immunotherapy and BiomarkersRenal cell carcinoma treatmentFerroptosis and cancer prognosis

Immune-related adverse events are associated with improved outcomes in ICI-treated renal cell carcinoma patients.

Elias, Roy, Yan, Flora, Singla, Nirmish, Levonyack, Nicholas, Formella, Joseph, Christie, Alana, Kapur, Payal, Bowman, Alex Isaac +3 more·2019·Journal of Clinical Oncology
DOI 10.1200/jco.2019.37.7_suppl.645
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Abstract

645 Background: With the approval of immune-checkpoint inhibitors (ICI) as first and second line agents for treating metastatic renal cell carcinoma (RCC), immune-related adverse events (irAE) are a growing concern. In this study, we present the safety profile and outcomes of 90 patients with RCC treated at two centers, including a university (UT Southwestern/Clements University Hospital) and a county hospital (UT Southwestern/Parkland). Methods: All patients with RCC treated with ICI were identified from 2013 to January 31, 2018. We examined the incidence of any treatment-related adverse events and “select” irAEs and evaluated their impact on patient outcomes and therapeutic decisions. Kaplan-Meier methods and Cox proportional hazards regression models were used to compare overall survival (OS) and time to next therapy (TTNT) by the presence of irAEs. Results: Of 90 patients treated with ICI, 65 (72.2%) patients experienced adverse events, most commonly fatigue (37.8%), nausea (14%), and decreased appetite (12.2%). Select irAEs were seen in 38 (42.2%) with the most common irAEs involving the skin (15.6%), gastrointestinal tract (14%), endocrine organs (11%), and lungs (7.8%). There were 15 (16.7%) grade III/IV irAEs resulting in cessation of therapy for 12 (13.3%) patients. The median OS was 35.9 (95% CI: 24.3-not reached) and 26.5 months (95% CI: 10.2-28.8; p = 0.002) for patients with and without irAEs, respectively. The median TTNT was 17.8 (95% CI: 11.3-29.3) and 6.6 months (95% CI: 4.5-9.6; p = 0.002) for patients with and without irAEs, respectively. In multivariate analysis of irAE status and Heng prognostic score, irAEs were associated with improved OS, HR 0.376 (95% CI 0.179–0.792; p = 0.010) and TTNT, HR 0.482 (95% CI 0.280–0.829; p = 0.008). Conclusions: ICI in RCC is well tolerated with only 16.7% of patients experiencing an adverse event resulting in cessation of therapy. The development of an irAE correlated with both an improved median OS as well as median TTNT, a benefit that persisted after multivariate analysis including Heng prognostic scoring. These findings suggest that the development of irAEs may be an independent positive prognostic factor in patients with RCC treated with ICI.

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Crossref · 10.1200/jco.2019.37.7_suppl.645

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  • Across disease sites, patients who experience IRAEs while on therapy with anti-PD-1 and anti-PD-L1 antibodies have been documented to experience improved outcomes as measured by overall response rate, progression-free survival and overall survival.

    “Across disease sites, patients who experience IRAEs while on therapy with anti-PD-1 and anti-PD-L1 antibodies have been documented to experience improved outcomes as measured by overall response rate (ORR), progression-free survival (PFS) and overall survival (OS) [13–20].”

    From Immune-related adverse events and anti-tumor efficacy of immune checkpoint inhibitors (2019) · cites this paper as [17]

  • In that experience, IRAEs were associated with improved time to next treatment (HR 0.48; 95% CI 0.28-0.83; p = .008).

    “and time to next treatment (HR 0.48; 95% CI 0.28–0.83; p = .008)”

    From Immune-related adverse events and anti-tumor efficacy of immune checkpoint inhibitors (2019) · cites this paper as [17]

  • In that experience, in a multivariate analysis of IRAEs and a prognostic risk score (Heng), IRAEs were associated with improved OS (HR 0.38; 95% CI 0.18-0.79; p = .01).

    “In a multivariate analysis of IRAEs and a prognostic risk score (Heng), IRAEs were associated with improved OS (HR 0.38; 95% CI 0.18–0.79; p = .01)”

    From Immune-related adverse events and anti-tumor efficacy of immune checkpoint inhibitors (2019) · cites this paper as [17]

  • In a two-center retrospective experience of 90 metastatic RCC patients on first- or second-line ICIs, 42.2% experienced IRAEs.

    “Of 90 patients treated with ICIs, 42.2% experienced IRAEs.”

    From Immune-related adverse events and anti-tumor efficacy of immune checkpoint inhibitors (2019) · cites this paper as [17]

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Authors
Elias, R., Yan, F., Singla, N., Levonyack, N., Formella, J., Christie, A., Kapur, P., Bowman, A. I., Hammers, H. J., Hannan, R., & Brugarolas, J.
Affiliations
  • The University of Texas Southwestern Medical Center (US)
  • University of Texas Southwestern Medical Center, Dallas, TX;
  • Harold C. Simmons Comprehensive Cancer Center (US)
ORCID
Venue
Journal of Clinical Oncology
Publisher
American Society of Clinical Oncology (ASCO)
Published
2019-03-01
Volume
37
Issue
7_suppl
Pages
645-645
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
DOI
10.1200/jco.2019.37.7_suppl.645
OpenAlex
W2921134389
Cited by
48
References
0
Citations by year
2026: 2 · 2025: 3 · 2024: 5 · 2023: 5 · 2022: 8 · 2021: 14 · 2020: 8 · 2019: 3
Type
conference abstract
Language
en
Open access
closed
Locations
Journal of Clinical Oncology (publishedVersion)
Topics
  • Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal cell carcinoma treatment
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Ferroptosis and cancer prognosis
Keywords
immune-related adverse events, immune checkpoint inhibitors, metastatic renal cell carcinoma, overall survival, time to next therapy, treatment discontinuation, immune-related pneumonitis, immune-related dermatitis, immune-related endocrine adverse events, fatigue, nausea, appetite loss, immunotherapy

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