Impact of First Line Antiangiogenic Therapy Duration on Nivolumab Outcome in Metastatic Renal Cell Carcinoma Patients Treated in the GETUG—AFU 26 NIVOREN

Guillemette Guilhem-Ducléon, Cécile Dalban, Sylvie Negrier, Gwenaelle Gravis, Brigitte Laguerre, Christine Chevreau, Stéphane Oudard, Philippe Barthelemy, Sylvain Ladoire, Elouen Boughalem, Delphine Borchiellini, Claude Linassier, Soazig Nenan, Ronan Flippot, Laurence Albiges, Marine Gross Goupil

    Résultats de recherche: Contribution à un journalArticleRevue par des pairs

    Résumé

    Background: In metastatic renal clear cell carcinoma (ccRCC), vascular endothelial growth factor receptor (VEGFR) and immune checkpoint are 2 main therapeutic targets. We investigated the impact of duration exposure to antiangiogenic on immunotherapy clinical outcomes in metastatic ccRCC. Methods: Patients from NIVOREN trial who received nivolumab after only 1 prior antiangiogenic therapy were included. Response rate, clinical benefit, progression free survival (PFS) and overall survival (OS) were prospectively analyzed depending on the duration of the first line (< 6 months, ≥6 months) and exploratory in patients with long first line exposure (≥18 months). The circulating levels of 8 plasma proteins and cytokines at baseline were collected and compared according to first line antiangiogenic duration. Results: Among 354 patients, 127 (36%) and 227 (64%) patients had received first line antiangiogenic for < 6months and ≥ 6months respectively. Respective duration of first line therapy was not associated with objective response to nivolumab (20.5% vs. 23.9%, P =.50), or PFS (HR 0.92; P =.421). Median OS was respectively 16.6 and 31.3 months in the <6 and ≥6 months subgroups respectively. Adjusted on international metastatic renal cell carcinoma database consortium risk, age and metastatic site, OS was longer in patients with longer treatment duration in the first line setting (HR 0.73; P =.017). Duration of first line VEGFR TKI was independent from circulating levels of 8 proteins and cytokines at nivolumab baseline. Conclusion: Nivolumab activity in second line is independent from first-line duration of VEGFR TKI. However, first line VEGFR TKI duration ≥ 6 months is associated with longer OS.

    langue originaleAnglais
    Pages (de - à)643-652
    Nombre de pages10
    journalClinical Genitourinary Cancer
    Volume21
    Numéro de publication6
    Les DOIs
    étatPublié - 1 déc. 2023

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