Long-term real-world outcomes of nivolumab plus ipilimumab for advanced renal cell carcinoma: a minimum of 4-years follow-up study

BACKGROUND: Data regarding long-term outcomes of nivolumab plus ipilimumab for previously untreated advanced renal cell carcinoma (RCC) in real-world patients are limited. METHODS: This retrospective study evaluated clinical data of 66 patients who received nivolumab plus ipilimumab with a minimum 4-years follow-up. Effectiveness and prognosis following deferred cytoreductive nephrectomy (CN) and treatment-free interval (TFI), as well as safety profiles, were assessed. RESULTS: During the follow-up (median 39.7 months), 54 (82%) and 29 (44%) patients had disease progression and died, respectively. Median progression-free survival and overall survival (OS) were 8.98 and 62.1 months, respectively. Objective response was observed in 32 patients (48%), and the median duration of response was 21.1 months. Deferred CN was conducted in seven patients (11%), and the 3-year OS rate after deferred CN was 86%. TFI for at least 6 months was obtained in 13 patients (20%), with a 3-year OS rate after treatment-off was 92%. Grade ≥ 3 adverse events occurred in 29 patients (44%), and 11 patients (17%) required high-dose glucocorticoids (≥40 mg of prednisone/day). CONCLUSION: Long-term follow-up data showed a feasible effectiveness and safety profile of nivolumab plus ipilimumab for real-world patients with advanced RCC. Although prognosis following deferred CN and TFI appeared favorable, prospective randomized trials are needed to confirm survival benefit of deferred CN and TFI.