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Courcier J, Dalban C, Laguerre B, Ladoire S, Barthélémy P, Oudard S, Joly F, Gravis G, Chevreau C, Geoffrois L, Deluche É, Rolland F, Topart D, Culine S, Négrier S, Mahammedi H, Tantot F, Jamet A, Escudier B, Flippot R, Albigès L. Primary Renal Tumour Response in Patients Treated with Nivolumab for Metastatic Renal Cell Carcinoma: Results from the GETUG-AFU 26 NIVOREN Trial. Eur Urol 2021; 80:325-329. [PMID: 34103181 DOI: 10.1016/j.eururo.2021.05.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/14/2021] [Indexed: 11/16/2022]
Abstract
Primary tumour response may impact therapeutic strategies in metastatic renal cell carcinoma (mRCC) but remains unknown in the era of immune checkpoint inhibitors. We aimed to describe the response of the primary tumour in patients who did not undergo upfront cytoreductive nephrectomy (uCN) and were treated with nivolumab in the GETUG-AFU-26 NIVOREN phase 2 trial. Primary tumour response was prospectively assessed, as well as the overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). Among 720 patients, 111 did not undergo uCN, mainly patients with intermediate (45%) and poor (49%) International mRCC Database Consortium (IMDC) risk. In the 111 patients, nivolumab was used in the second line for 63% of patients and the third line or more for 37%, with an ORR of 16% (95% confidence interval [CI] 1025%); with a median follow-up of 24.5 mo (95% CI 21.6-27.1), median PFS was 2.7 mo (95% CI 2.5-4.0) and median OS was 15.9 mo (95% CI 9.5-19.8). A total of 67 patients had an evaluable primary renal lesion, four of whom (6%) experienced shrinkage of more than 30%. Overall, patients who did not undergo uCN had adverse baseline characteristics and nivolumab activity against the primary tumour was limited. PATIENT SUMMARY: In this report, we observed that nivolumab was associated with a limited response of the primary tumour in previously treated patients with metastatic kidney cancer.
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Affiliation(s)
- Jean Courcier
- Department of Urology, UPEC-Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | | | | | | | | | - Stéphane Oudard
- Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Gwénaëlle Gravis
- Medical Oncology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | | | - Lionel Geoffrois
- Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | | | | | - Delphine Topart
- Department of Medical Oncology, Montpellier University Hospital, Hôpital Saint Eloi, Montpellier, France
| | - Stéphane Culine
- Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | - Antoine Jamet
- Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Bernard Escudier
- Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Ronan Flippot
- Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Laurence Albigès
- Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France.
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