In this study presented at the American Society of Clinical Oncology Genitourinary Cancers (ASCO GU) Symposium last month, treatment-free survival for advanced kidney cancer patients on nivolumab and salvage nivolumab plus ipilimumab was presented.
Immunotherapy can control kidney cancer after the treatment has stopped without the need for further anticancer therapy. Unfortunately, side effects from immunotherapy can also continue when the treatment has been stopped. In previous studies, significant treatment-free survival has been reported for patients with advanced melanoma or advanced kidney cancer, but treatment was often stopped because of side effects. In the current study, the researchers wanted to reduce side effects by capping the duration of immunotherapy.
128 patients with clear-cell advanced kidney cancer were treated first with nivolumab for up to 2 years. The nivolumab/ipilimumab combination (salvage therapy) was given for up to 1 year to those patients whose cancer got worse at any point during the study or was stable at 4 years. Salvage therapy was given to 28% of patients.
The average time on treatment was nearly 1 year and the average treatment-free survival time was 9.4 months. For patients with favourable risk disease the average treatment-free survival time was just over a year. Serious or life-threatening side effects lasted 1.5 months during the treatment-free period. For patients with intermediate or poor risk disease, the average treatment-free survival time was 8 months, and serious or life-threatening side effects lasted an average of 1 month. At 3 years, 65.6% of favourable risk patients and 27.1% of intermediate/poor risk patients were alive and remained treatment-free.
In conclusion, nivolumab with salvage nivolumab/ipilimumab in patients who didn’t respond to nivolumab alone is an active treatment approach in untreated patients with advanced kidney cancer. This treatment schedule resulted in extended treatment-free and side effect free survival, particularly in patients with favourable risk disease.