Radiation before immunotherapy does not affect outcomes in metastatic renal cell carcinoma
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Radiation prior to combination immunotherapy did not influence clinical outcomes among patients with metastatic renal cell carcinoma and bone metastases, according to study results presented at International Kidney Cancer Symposium.
“Overall clinical outcomes were poor in this population,” Hesham A. Yasin, MD, of Vanderbilt University Medical Center, and colleagues wrote.
Prior retrospective studies and post-hoc analyses have revealed worse outcomes among patients with metastatic renal cell carcinoma and bone metastases. Some evidence suggested a potential synergistic relationship between radiation and immunotherapy, according to study background.
Yasin and colleagues conducted a single-center retrospective analysis of 28 patients with metastatic renal cell carcinoma and bone metastases treated with immunotherapy-based combination therapy at Vanderbilt-Ingram Cancer Center.
Researchers compared outcomes of patients who received radiation therapy in the prior 6 months (n = 12) vs. those who had not (n = 16).
The groups appeared balanced with regard to age (median, 56 years vs. 57 years), clear cell histology (83% vs. 81%), International Metastatic RCC Database Consortium risk (intermediate/poor, 91.6% vs. 87.5%) and receipt of prior systemic therapy (25% each).
In the prior radiation therapy group, nine patients (75%) received ipilimumab (Yervoy, Bristol Myers Squibb) with nivolumab (Opdivo, Bristol Myers Squibb), two (16.6%) received pembrolizumab (Keytruda, Merck) with axitinib (Inlyta, Pfizer), and one (8.3%) received avelumab (Bavencio; EMD Serono, Pfizer) with axitinib. In the no-radiation group, eight patients (50%) received ipilimumab with nivolumab, and eight (50%) received pembrolizumab with axitinib.
A higher percentage of patients in the no-radiation group underwent prior nephrectomy (81% vs. 42%).
Researchers reported comparable response rates between the no-radiation and radiation groups (19% vs. 17%; OR = 0.87; 95% CI, 0.12-6.21).
Results showed no major differences in median PFS (3.5 months vs. 2.8 months; HR = 1.05; 95% CI, 0.46-2.3) or median OS (18.8 months vs. not reached; HR = 0.2; 95% CI, 0.03-1.62) between the no-radiation and radiation groups.
“Further studies are needed to evaluate the role of [radiation therapy] prior to immunotherapy,” Yasin and colleagues concluded.
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Yasin H, et al. Abstract N20. Presented at: International Kidney Cancer Symposium; Nov. 5-6, 2021; Austin, Texas.
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