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    Should RCC immunotherapy continue after progression?


    Of the 153 patients treated beyond progression, 29 had a complete/partial response as their best response before being treated beyond progression, 47 had stable disease, and 66 had progressive disease. Rates of ≥30% reduction in tumor burden with nivolumab treatment beyond progression achieved in these three subgroups were 28%, 6%, and 14%, respectively.

    Comparing patients who achieved a ≥30% reduction in tumor burden when treated with nivolumab beyond progression with their counterparts not treated beyond progression showed the former group had a better median quality of life and included a higher proportion of patients with a favorable Memorial Sloan Kettering Cancer Center risk score and with lung metastases.

    Comparisons of characteristics of patients treated with nivolumab beyond progression and those who were not found no difference between the two groups in the frequency of treatment-related adverse events from randomization to first progression. However, the patients treated beyond progression had better Karnofsky performance status, less deterioration in Karnofsky performance status, shorter time to response, lower incidence of new bone lesions, and better quality of life.

    Also see: Has the USPSTF gone far enough with its new PCa grade?

    It was noted that data on the investigators’ rationale for treating patients beyond progression were not available. The more favorable characteristics of the patients treated beyond progression may have influenced the investigators’ decision to continue nivolumab treatment but also impacted their survival.

    With the aim of avoiding excessive duration of therapy, the authors stated that further investigations are warranted to better determine which patients may benefit from treatment beyond progression.

    The study was sponsored by Bristol-Myers Squibb and Ono Pharmaceutical Co., Ltd. Dr. Escudier has received honoraria from Bayer, Bristol-Myers Squibb, Exelixis, Novartis, and Pfizer. Several of his co-authors have a financial and/or other relationship with pharmaceutical companies.

    More from Urology Times:

    Small molecule RNA inhibitor shows promise in PCa

    Combination immunotherapy may raise response rate in mRCC

    PCa immunotherapy: Response better when given before ADT

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