engleski

Nivolumab in clinical practice: real world experince in the University hospital Split

Background: Immunotherapy has demonstrated promising results in cancer patients. Immune checkpoint inhibition with the anti- PD-1 antibody nivolumab has improved survival in metastatic lung cancer, renal cancer and melanoma patients. The toxicity profile of nivolumab was acceptable in clinical trials. We describe here the experience with nivolumab compassionate program at the Clinic of Oncology - University Hospital Split. Methods: A total of 116 patients with metastatic non small cell lung cancer, renal cancer and melanoma who were already treated with one or more lines of systemic therapy were included. Nivolumab dose was 3 mg/kg every two weeks. Maximal treatment duration was 2 years. All patients who received at least one dose of nivolumab were evaluated for toxicity and efficacy. Results: Median patient's age was 62, 5 years. 111 (95%) patients were ECOG status 0-1 and 5 patients were ECOG status 2. There were 88 (75%) lung cancer, 25 (21%) renal cancer and 2 melanoma patients. Brain metastases had 17% lung cancer patients, one renal cancer patient and none with melanoma. Before nivolumab treatment 58% of patients were treated with 2 or more lines of systemic therapy and radiotherapy was given to 47% of patients with lung cancer, to 44% of renal cancer patient and to none with melanoma. 21 patients (18%) received 1-5 cycles of nivolumab and they don't have radiological evaluation of treatment response. The response rate was 32% (complete response in 2% and partial response in 30% of patients), while stable disease was revealed in 35% of patients. Median progression free survival was 3, 4 months. Median overall survival was 10 months. Most common adverse effects were rash, anemia and hypothyreosis grade 1 in 13%, 8% and 6% of patients. Most common adverse effect grade 3 was diarrhoea in 1, 7% of patients, rash, liver toxicity and hypothyreosis in 0, 8% patients. Ophthalmic herpes zoster was revealed in 2 and pneumonitis in one patient. Treatment was discontinuated in one patient due to the miastenia gravis. Conclusion: Treatment with nivolumab in pretreated patients with metastatic non small cell lung cancer, renal cancer and melanoma in every day clinical practice was effective and well tolerated.

Nivolumab ; clinical practice

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