Nivolumab用於轉移性腎細胞癌初步報告

陳韋辰、李建儀、陳卷書、楊晨洸、林嘉彥、程千里、裘坤元

台中榮民總醫院外科部泌尿科

Nivolumab in metastatic renal cell carcinoma preliminary report

Wei-Cheng, Chen, Jian‐Ri, Lee, Chuan-Shu, Chen, Cheng-Kuang, Yang, Chia-Yen, Lin, Chen-Li, Cheng, Kun-Yuan, Chiu

Divisions of Urology, Department of Surgery, Taichung Veteran General Hospital, Taiwan

Purpose: We analysis immune checkpoint inhibitor Nivolumab treatment in metastatic renal cell carcinoma response in a single institute.

Materials and Methods: A total 11 metastatic renal cell carcinoma patients were retrospectively studied. We investigated their demographic information, pathlogy cell type, IMDC risk group, systemic treatment regimen, time, response, nephrectomy, metastatectomy, side effect and survival.

Results: Of 11 patients receiving Nivolumab for metastatic renal cell carcinoma, the median age was 61 (37-76), men were more than women(male: female= 8:3). 8 concentional clear cell type, 1 chromophobe RCC, 1 papillary RCC, and 1 unclassified RCC. Nephrectomy was performed in 9 patients, while metastatectomy was done in 9 patients. 2 patients were categorized in favorable IMDC risk group, 4 in intermediate risk group, and 5 in poor risk group. Median systemic treatment time before Nivolumab was 2 years and 8 months (994 days), median tyrosine kinase inhibitor used time was 2 years (735 days), and median mTOR used time was 2.5 months (77 days). Among 11 patints receiving Nivolumab as immunotherapy or metastatic renal cell carcinoma, one has complete response, 3 has partial response, 1 has stable disease, but 5 has progressive disease and 2 patient expired due to terminal cancer cachexia. One just started treatment and not evaluated yet since shifting to Nivolumab. Most observed side effect was hypothyroidism, which happened in 5 cases and grade 1 skin rash in 2 patients.

Conclusions: Nivolumab treatment has good treatment response for metastatic renal cell carcinoma to selected group of patient, and has minor or no side effect, while progressive disease still happened in other group. Further analysis is indicated to enhance treatment effect for best outcome.