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Nivolumab alone and in combination with ipilimumab is used for the treatment of patients with metastatic renal cell carcinoma (RCC) in the second- and first-line, respectively. However, since patients with non-clear cell RCC are excluded from clinical trials, there is limited data on the effectiveness of nivolumab for the treatment of these patients.
In a recent paper published in The Oncologist, the records of patients who received nivolumab for non-clear cell RCC and clear cell RCC with >20% rhabdoid were reviewed. The researchers looked at objective response rate, progression-free survival and overall survival. The researchers also reviewed the literature to identify studies reporting on the clinical activity of immune checkpoint inhibitors in patients with non-clear cell RCC.
They identified 32 patients with non-clear cell RCC (12 papillary, 11 unclassified, 5 chromophobe, 3 translocation, 1 mucinous tubular and spindle cell carcinoma) and 8 clear cell RCC with rhabdoid component. Overall, seven patients had an objective response, including three patients who achieved a complete remission. Median progression-free survival was 4.9 months after a median follow-up of 24.5 months. Median overall survival was 21.7 months. There were no treatment-related deaths.
In this retrospective study, nivolumab demonstrated clinical activity in non-clear cell RCC and clear cell RCC with >20% rhabdoid component. Further prospective randomised clinical trials are needed.