Department of Urology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama City, Osaka, 589-8511, Japan.
Department of Urology, Department of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachi-dori, Chuo Ward, Niigata City, Niigata, 951-8510, Japan.
Int J Clin Oncol. 2022 Jun;27(6):1061-1067. doi: 10.1007/s10147-022-02155-3. Epub 2022 Apr 20.
This all-case post-marketing surveillance (PMS) evaluated the real-world safety and effectiveness of nivolumab monotherapy in Japanese patients with un-resectable or metastatic renal cell carcinoma (RCC).
This multicenter, open-label, non-interventional, observational PMS study (registered from August 2016 to January 2017) was conducted in patients who were newly initiated on nivolumab monotherapy. Assessments included treatment-related adverse events (TRAEs) of special interest, patient characteristics affecting safety, and effectiveness over 12 months.
Overall, 580 patients were enrolled; 555 and 554 patients comprised the safety and effectiveness analysis sets, respectively. The median (range) age of the population was 66 (14-90) years. Nivolumab was initiated as 1st-, 2nd-, and ≥ 3rd-line treatment in 0.2%, 42.0%, and 57.8% of patients, respectively. TRAEs were reported in 275 (49.5%) patients. The most common TRAEs of special interest included thyroid dysfunction (9.5%), hepatic dysfunction (8.6%), and interstitial lung disease (6.7%). The incidence of TRAEs was significantly higher in elderly patients (≥ 65 vs < 65 years; ≥ 75 vs < 75 years); patients with lower C-reactive protein levels (< 5 vs ≥ 5 mg/dL); and patients with vs without a past medical history, including hepatic, thyroid, and autoimmune diseases. The 6- and 12-month survival rates were 71.8% and 57.9%, respectively.
The safety profile of nivolumab monotherapy in Japanese patients with advanced RCC was similar to that in the phase 3 CheckMate 025 trial. No new safety signals were observed in this study.
本项全病例上市后监测(PMS)评估了纳武利尤单抗单药治疗日本不可切除或转移性肾细胞癌(RCC)患者的真实世界安全性和有效性。
本项多中心、开放标签、非干预性、观察性 PMS 研究(2016 年 8 月至 2017 年 1 月注册)入组了新开始纳武利尤单抗单药治疗的患者。评估包括特别关注的治疗相关不良事件(TRAEs)、影响安全性的患者特征以及 12 个月的有效性。
总体而言,580 例患者入组;555 例和 554 例患者分别纳入安全性和有效性分析集。人群的中位(范围)年龄为 66(14-90)岁。纳武利尤单抗作为一线、二线和三线治疗分别在 0.2%、42.0%和 57.8%的患者中开始。275(49.5%)例患者报告了 TRAEs。最常见的特别关注 TRAEs 包括甲状腺功能障碍(9.5%)、肝功能障碍(8.6%)和间质性肺病(6.7%)。TRAEs 的发生率在老年患者(≥65 岁 vs <65 岁;≥75 岁 vs <75 岁)、C 反应蛋白水平较低(<5 与≥5mg/dL)的患者以及有既往病史(包括肝脏、甲状腺和自身免疫性疾病)与无既往病史的患者中显著更高。6 个月和 12 个月的生存率分别为 71.8%和 57.9%。
纳武利尤单抗单药治疗日本晚期 RCC 患者的安全性与 III 期 CheckMate 025 试验相似。本研究未观察到新的安全性信号。