Examination of irAE and treatment discontinuation irAE in patients with RCC with T effector phenotype.

• DOI: 10.1200/jco.2024.42.16_suppl.4549
• Publication Date: 2024-07-01T18:12:25Z
• Authors: Catherine Fahey; Anupama Reddy; Kristin Kathleen ...; Kerry Roe Schaffer; Brian I. Rini; Katy Beckermann
• Keywords: Discontinuation

4549 Background: The standard of care for renal cell carcinoma (RCC) is physician-choice dual immunotherapy with ipilimumab/nivolumab (IO/IO) or a combination VEGF inhibitor (VEGF/IO). IMmotion 151 trial identified gene expression signatures that differentiate likelihood response to IO/IO (cluster 4 and 5 – T effector) versus VEGF/IO 1 2 - Angiogenic). Given the effector RNA-seq signature consists higher genes associated inflammation, we hypothesized patients phenotype would have rates immune-related adverse events (irAE) on IO-based therapy. Methods: Patients metastatic RCC treated systemic therapy had RNA sequencing completed primary tumor site. Charts who were manually curated identify development irAE by reading most recent clinic note searching ‘steroids’, ‘irAE’, ‘rash’, ‘thyroid’. Hits from searches investigated manual chart review. Results: 118 underwent 105 passed quality control. Nineteen (18%) assigned phenotype. Of 17 patients, twelve these received at least one dose in first second line therapy, five Among IO/IO, 8 developed any grade (66%; 41% 3+), (41%) required steroid treatment, hospitalization, (33%) discontinued treatment due irAE. Grade 3 toxicities this group included colitis, adrenal insufficiency, hypophysitis. VEGF/IO, (60%; 20% none steroids, hospitalized. toxicity was insufficiency. Conclusions: ofirAE than historic controls when leading high use discontinuation. VEGF/IO-treated similar controls. ongoing OPTIC clinical will expand results studying assignment prospective manner.