Administration of Nivolumab in Metastatic Renal Cell Cancer Following Treatment With mTOR Inhibitors

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Authors	KOPECKY Jindrich KUBECEK Ondrej BUCHLER Tomas MELICHAR Bohuslav POPRACH Alexandr ZEMANOVA Milada KATOLICKA Jana KISS Igor HAJEK Jaroslav STUDENTOVA Hana SPISAROVA Martina
Year of publication	2021
Type	Article in Periodical
Magazine / Source	In vivo
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://iv.iiarjournals.org/content/35/5/2981
Doi	http://dx.doi.org/10.21873/invivo.12593
Keywords	Renal cell cancer; nivolumab; mTOR inhibitor; neutrophil-lymphocyte ratio; platelet-lymphocyte ratio; systematic inflammation index
Description	Background/Aim: Immunotherapy with checkpoint inhibitors is currently considered a cornerstone of metastatic renal clear cell cancer (mRCC) therapy. Despite the general improvement in the survival of patients with mRCC, there are some clinical situations that have not been specifically evaluated in clinical trials, such as the use of everolimus before nivolumab. Patients and Methods: We performed a retrospective analysis evaluating the efficacy of nivolumab in the real-world setting, including a subset of patients with previous mTOR inhibitor therapy. Results: From a total of 56 patients, 25 were pre-treated with everolimus before receiving nivolumab. The overall progression-free survival (PFS), overall survival (OS), and objective response rate were 10.3, 21.3 months, and 34%, respectively. There were no statistically significant differences in patients who were or were not pretreated with everolimus. Conclusion: mRCC patients should be treated with checkpoint inhibitors and prior use of mTOR inhibitors should not be a definitive exclusion criterium.