Real-World Efficacy and Toxicity of Ipilimumab and Nivolumab as First-Line Treatment of Metastatic Renal Cell Carcinoma (mRCC) in a Subpopulation of Elderly and Poor Performance Status Patients

Abstract

The results of a large, randomized control trial demonstrated improved survival and quality of life with ipilimumab and nivolumab immunotherapy compared to oral targeted therapy with sunitinib. Elderly patients and those with poor performance status are often excluded from clinical trials despite comprising a significant proportion of patients seen in the clinical setting. As a result, there is limited information to guide treatment for these patient groups. Our study analyzed real-world patient data of 551 patients with metastatic renal cell cancer from the Canadian Kidney Cancer information system (CKCis) database to assess the clinical outcomes of ipilimumab and nivolumab for older and less fit patients compared to younger and more fit cohorts. We found no difference in outcomes for elderly compared to younger patients. However, patients with poor performance status had poorer overall survival and shorter response to treatment compared to more fit patients.