SPR (ST4) NHS GREATER GLASGOW AND CLYDE, Scotland, United Kingdom
Background: Ipilimumab + Nivolumab (IPI+NIVO) and Pembrolizumab + Axitinib (PEM+AXI) are two first line treatment options for advanced RCC based on results of the CheckMate-214 and KEYNOTE-426 trials. In this RWE study, we compared the efficacy and toxicity between IPI+NIVO and PEM+AXI at a single cancer centre.
Methods: Electronic medical records of patients (pts) at the Beatson West of Scotland Cancer Centre, on IPI+NIVO (June 2019 to January 2021) and PEM+AXI (May 2020 to June 2021) were reviewed. Data on patient demographics, histopathology, metastatic sites, IMDC risk, response and adverse events were collected.
Results: 32 and 93 pts were identified in the IPI+NIVO and PEM+AXI cohorts (Table 1). At data cut off, with a median follow-up of 15 months (range: 0-42) in IPI+NIVO and 7 months (range: 0-15) in PEM+AXI, 10 pts (31%) and 73 pts (78%) were alive respectively. Objective response rate (ORR) was 53% and 56% for IPI+NIVO and PEM+AXI and clinical benefit rate (ORR and stable disease) was seen in 26 patients (81%) and 72 patients (83%). Disease progression was seen in 9 patients (31%) for IPI+NIVO and 24 patients (26%) for PEM+AXI. Median overall and progression free survival were not reached. Immune related AE (irAE) of any grade occurred in 22 patients (68%) on IPI+NIVO and in 60 patients (65%) on PEM+AXI whilst grade 3/4 irAE were seen in 8 patients (25%) and 19 pts (20%) respectively. 12 (37%) and 6 patients (18%) on IPI+NIVO and 28 (30%) and 14 pts (15%) on PEM+AXI required steroids and hospitalisation for irAE, with a median stay of 6 days in both (range:2-40 days.
Conclusions: Our RWE demonstrates that IPI+NIVO appears to have comparable efficacy to PEM+AXI. Further follow up continues and updated data will be presented. As expected, irAE rates were higher in the combined immunotherapy regimen.