University of Utah Huntsman Cancer Institute, Salt Lake City, UT
Joseph Merriman , Kinjal Parikh , Srinivas Kiran Tantravahi , Alli M. Straubhar , Archana M. Agarwal , Arun Sendilnathan , Joan Van Atta , Julia A. Batten , Kenneth F. Grossmann , Wolfram E. Samlowski , David D. Stenehjem , Neeraj Agarwal
Background: HD IL-2 is a standard of care for selected pts with mRCC. Generally objective responses (OR), i.e. complete response (CR) + partial response (PR), of 16-20% are discussed with pts, and not SD. Recent data suggest that cancer immunotherapy may improve survival without inducing OR. Thus, HD IL-2 may provide survival benefit to an additional group of pts not experiencing OR, but only SD as the best response. Methods: All sequential cc mRCC pts treated with HD IL-2 at the University of Utah (1988-2012) were included. Two practitioners independently assessed responses. Best responses were correlated with survival outcomes using Kaplan-Meier analysis. Results: A total of 176 pts (79% male; median age 55 yrs, range 13-76) were included and belonged to the following MSKCC risk categories: 51 (29%) good, 115 (65%) intermediate, and 10 (6%) poor. A CR was identified in 16 (9%), PR in 11 (6%), SD in 52 (30%), progressive disease (PD) in 68 (39%), and not evaluable for response (NE) in 29 (16%) pts. Median overall survival (OS) by risk category for the favorable, intermediate and poor groups was 47.6 (p=0.0005 vs intermediate), 18.0 (p<0.0001 vs poor), and 5.4 (p<0.0001 vs favorable) months (mo), respectively. Table shows correlation of best response with survival outcomes. Conclusions: A clinical benefit of HD IL-2 wasachieved in nearly half of all cc mRCC pts. SD was associated with clinically relevant survival outcomes. There was no statistical difference in outcomes between pts achieving a PR or SD. SD is an important response criterion for treatment with HD IL-2, and may be discussed with pts.
PFS, mos | OS, mos | |
---|---|---|
Overall | 5.6 | 19.9 |
CR vs PR | 113.8 vs 14.8 (HR 0.34, CI 0.12-0.95) | 182.0 vs 37.8 (HR 0.23, CI 0.06-0.74) |
CR vs SD | 113.8 vs 11.0 (HR 0.22, CI 0.09-0.47) | 182.0 vs 29.2 (HR 0.16, CI 0.04-0.41) |
SD vs (PD and NE) | 11.0 vs 2.6 (HR 0.40, CI 0.28-0.58) | 29.2 vs 9.7 (HR 0.42, CI 0.28-0.61) |
OR vs (SD, PD and NE) | 40.3 vs 4.3 (HR 0.27, CI 0.15-0.44) | 83.5 vs 16.3 (HR 0.24, CI 0.13-0.42) |
PR vs SD | 14.8 vs 11.0 (HR 0.64, CI 0.28-1.31) | 37.8 vs 29.2 (HR 0.68, CI 0.29-1.41) |
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Abstract Disclosures
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First Author: David D. Stenehjem
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