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Low-Dose Nivolumab ...
Low-Dose Nivolumab in Renal Cell Carcinoma: A Real-World Experience
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Zhao, JJ (författare)
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Kumarakulasinghe, NB (författare)
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Muthu, V (författare)
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Lee, M (författare)
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Walsh, R (författare)
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Low, JL (författare)
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Choo, J (författare)
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Tan, HL (författare)
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Chong, WQ (författare)
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Ang, Y (författare)
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Chan, G (författare)
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Yong, WP (författare)
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Huang, YQ (författare)
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Ngoi, N (författare)
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Wong, A (författare)
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- 2021-01-13
- 2021
- Engelska.
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Ingår i: Oncology. - : S. Karger AG. - 1423-0232 .- 0030-2414. ; 99:3, s. 192-202
- Relaterad länk:
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http://kipublication...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- <b><i>Background:</i></b> The approved doses of the single agent nivolumab – an anti-programmed cell death protein 1 (PD-1) monoclonal antibody – for renal cell carcinoma (RCC) are 3 mg/kg and a 240-mg flat dose, despite efficacy shown at lower doses in earlier CheckMate trials. In view of financial constraints, the minimum dose of nivolumab required for efficacy remains a critical area of inquiry. <b><i>Methods:</i></b> A retrospective review of RCC patients receiving single-agent anti-PD-1 treatment was conducted. Using the median cutoff of the maximum dose per body weight received, we investigated the effect of lower dosages on overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and immune-related adverse event-free survival (irAE-FS). Survival analysis was made by Kaplan-Meier, by uni- and multivariable Cox models, and by modeling the statistical interaction between dosages and survival. <b><i>Results:</i></b> 32 patients were recruited: 8 patients (25%) receiving first-line treatment and 24 (75%) receiving second-line treatment and beyond. A median split at 2.15 mg/kg yielded 16 patients in both the lower-dose (LD) and the higher-dose (HD) cohort. Hazard ratios (HRs) demonstrated no difference in OS after adjustment for gender (HR = 0.22, 95% CI 0.05–1.05, <i>p</i> = 0.054; favoring LD), as well as in PFS after adjustment for gender and concurrent radiation therapy (HR = 0.58, 95% CI 0.25–1.34, <i>p</i> = 0.210; favoring LD). No differences in ORR were observed (50.0 vs. 43.8%, <i>p</i> = 1.00, in the LD and the HD cohort, respectively). Immune-related phenomena were observed in the LD group, including pseudoprogression and increased all-grade immune-related toxicities (irAE-FS: HR = 1.72, 95% CI 0.48–6.14, <i>p</i> = 0.293; favoring HD). Iterative dichotomization of dosages showed no dose-OS or dose-irAE-FS relationship. <b><i>Conclusion:</i></b> Our study suggests no apparent reduction in efficacy when using a low-dosage nivolumab regimen.
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Oncology
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Till lärosätets databas
- Av författaren/redakt...
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Zhao, JJ
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Kumarakulasinghe ...
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Muthu, V
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Lee, M
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Walsh, R
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Low, JL
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visa fler...
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Choo, J
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Tan, HL
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Chong, WQ
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Ang, Y
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Chan, G
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Yong, WP
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Huang, YQ
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Ngoi, N
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Wong, A
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visa färre...
- Artiklar i publikationen
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Oncology
- Av lärosätet
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Karolinska Institutet