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At the American Society of Clinical Oncology Genitourinary Cancers Symposium (ASCO GU) last weekend, the use of immunotherapy for the treatment of people with kidney cancer brain metastases was looked at. Because people with spread of their kidney cancer to the brain are often excluded from clinical trials, there is not a lot of information about the outcomes of these patients when treated with first-line therapies.
In this study, 775 patients with brain metastases from kidney cancer were assessed. About 10% of them were taking immunotherapy combination treatments (either immunotherapy plus VEGF TKI or immunotherapy plus immunotherapy), while the remainder were on a VEGF TKI (sunitinib or pazopanib). A quarter of the patients on an immunotherapy combination also had whole brain radiotherapy, while more than half of the patients on a VEGF TKI were given this treatment.
The patients who were treated with an immunotherapy combination had the best overall response to treatment in all disease sites. 3.4% had a complete response, just over a quarter had a partial response and nearly 40% had stable disease. However, in the patients treated with a VEGF TKI, less than 1% had a complete response, nearly 30% had a partial response and just over a third had stable disease.
Favourable or moderate risk disease, treatment with an immunotherapy combination, brain surgery to remove metastases and stereotactic radiotherapy (radiation beams targeted directly at the metastases) improved overall survival time for patients with brain metastases from kidney cancer.