Session: MP28: Kidney Cancer: Advanced (including Drug Therapy) I
MP28-10: Comparison of the Impacts of Immune-related Adverse Events on the Prognosis of Patients with Advanced Renal Cell Carcinoma between Patients Treated with IO-IO and IO-TKI Combination Therapy
Introduction: Several studies have highlighted the prognostic impact of immune-related adverse events (irAEs) in patients with solid cancers including renal cell carcinoma (RCC) treated with immune checkpoint inhibitors (ICIs). However, similar data in patients with advanced RCC treated with ICI-based combination therapy as first-line therapy are scarce. Methods: We retrospectively evaluated the data of 148 patients with advanced RCC receiving either ICI-dual combination therapy (i.e., IO-IO) or ICI plus tyrosine kinase inhibitor (TKI) combination therapy (i.e., IO-TKI) as first-line therapy at our affiliated institutions. Between the IO-IO and IO-TKI regimens groups, progression-free survival (PFS), overall survival (OS), and objective response rates (ORRs) were compared. Results: Overall, a significantly higher proportion of patients experienced at least one irAEs during treatment in the IO-IO than in the IO-TKI group [67/91 (74%) vs. 30/57 (53%), respectively; p=0.0126]. PFS (median: 11.8 vs. 2.50 months, p<0.0001), OS (median: not reached vs. 31.0 months, p=0.0102), and ORR (55% vs. 17%, p=0.0028) were significantly superior in patients with irAEs than in those without irAEs in the IO-IO group (Figure 1). Multivariate analyses further showed that irAE development was an independent prognostic factor for longer PFS (hazard ratio: 0.25, p<0.0001) and OS (hazard ratio: 0.42, p=0.0287) in the IO-IO group. Contrarily, irAE development was not associated with PFS (median: 37.9 vs. 16.1 months, p=0.894), OS (not reached vs. not reached, p=0.846), or ORR (53% vs. 56%, p=0.539) in the IO-TKI group (Figure 2). Conclusions: In the first-line setting of systemic therapy for advanced RCC, the IO-IO regimen was associated with a higher incidence rate of irAEs than the IO-TKI regimen. Depending on the regimen used, the prognostic impact of irAEs might be different, even though we need appropriate optimal treatment for irAEs regardless of the regimens. SOURCE OF Funding: None.
