• BJU international · Jan 2019

    Safety and efficacy of nivolumab for metastatic renal cell carcinoma: real-world results from an expanded access programme.

    • Ugo De Giorgi, Giacomo Cartenì, Diana Giannarelli, Umberto Basso, Luca Galli, Enrico Cortesi, Claudia Caserta, Sandro Pignata, Roberto Sabbatini, Alessandra Bearz, Sebastiano Buti, Giovanni Lo Re, Alfredo Berruti, Sergio Bracarda, Francesco Cognetti, Francesca Rastelli, Giuseppe Fornarini, Camillo Porta, Daniele Turci, Cora N Sternberg, Giuseppe Procopio, and Italian Nivolumab Renal Cell Cancer Early Access Program Group.
    • Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) - IRCCS, Meldola, Italy.
    • BJU Int. 2019 Jan 1; 123 (1): 98-105.

    ObjectiveTo report the safety and efficacy results of patients enrolled in the Italian Nivolumab Renal Cell Cancer Expanded Access Programme.Patients And MethodsPatients with metastatic renal cell cancer (mRCC) previously treated with agents targeting the vascular endothelial growth factor pathway were eligible to receive nivolumab 3 mg/kg once every 2 weeks. Patients included in the analysis had received ≥1 dose of nivolumab and were monitored for adverse events (AEs) using Common Terminology Criteria for Adverse Events (CTCAE) v.4.0.ResultsA total of 389 patients were enrolled between July 2015 and April 2016, of whom 18% were aged ≥75 years, 6.7% had non-clear cell RCC, 49.6% had bone and 8.2% brain metastases, and 79% had received ≥2 previous lines of therapy. The most common any-grade treatment-related AEs were fatigue (13%) and rash (9%). Twenty-two patients (5.7%) discontinued treatment because of AEs. There were no treatment-related deaths. The objective response rate was 23.1%. At a median follow-up of 12 months, the median progression-free survival was 4.5 months (95% confidence interval 3.7-6.2) and the 12-month overall survival rate was 63%. Similar survival rates were reported among patients with non-clear-cell histology, elderly patients, those with bone and/or brain metastases, and those who had received prior first-line sunitinib or pazopanib, or prior everolimus.ConclusionThe safety and efficacy observed were consistent with those reported in the pivotal Checkmate 025 trial. Results in patients with non-clear-cell mRCC who were elderly, pretreated with everolimus, and had bone and/or brain metastases encourage the use of nivolumab in these categories of patients.© 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

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