Real-world data show that objective imaging response correlates with improved survival among patients with metastatic renal cell carcinoma (mRCC). Objective imaging response was more likely after first-line immunotherapy plus vascular endothelial growth factor receptor inhibitor (IOVE) combination therapy than after ipilimumab-nivolumab (IOIO) combination therapy.

Among 899 patients with mRCC who received first-line immunotherapy combination therapies in the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC), 4.1% had complete response, 38.3% had partial response, 35.0% had stable disease, and 22.6% had progressive disease. Median overall survival was significantly longer for patients with a partial response compared with those with stable or progressive disease (55.9 vs 48.1 vs 13.0 months, respectively), Vishal Navani, MBBS, of the University of Calgary in Canada and colleagues reported in JAMA Network Open. Survival was not estimable among the few patients with complete response. Time to next treatment also was prolonged among patients with objective imaging response.

Treatment with IOVE therapy was significantly associated with 1.9-fold increased odds of objective imaging response compared with IOIO therapy. Among disease features, lung metastases, cytoreductive nephrectomy, and favorable IMDC risk were significantly associated with a 1.5-, 1.6-, and 1.9-fold increased likelihood of objective imaging response, respectively.

“These findings may help inform treatment selection, especially in clinical contexts associated with high-volume multisite metastatic disease, in which obtaining objective imaging response is important,” according to Dr Navani’s team.

The investigators noted that this is the largest analysis characterizing objective imaging response among patients with mRCC treated in routine clinical practice.

Imaging Response to Immunotherapy Combination Therapies in mRCC

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