Dr Hajj Chehade on Potential Risk Factors for irAE Development in mRCC

Razane El Hajj Chehade, MD, Research Fellow in Medicine, Department of Medicine, Dana-Farber Cancer Institute discusses the association between different histologic subtypes in renal cell carcinoma (RCC) and the risk of developing immune-related adverse effects (irAEs), as investigated in a retrospective study.

The study enrolled patients with metastatic RCC from the Dana Farber Cancer Institute who were treated with immune checkpoint inhibitor (ICI) combination therapy, Hajj Chehade begins. This could include either an immune-oncology (IO)/IO regimen or an IO/VEGF combination. The primary objective of the study was to identify risk factors associated with the development of irAEs in this patient population, Hajj Chehade states.

Patients were split into 2 groups: those who developed grade 2 or higher irAEs and those who experienced grade 1 or no irAEs, she details. The primary outcome measured in the study was time to toxicity (TT). Univariate and multivariate cox regression analyses were used to identify potential predictive factors for irAEs, adjusting for various baseline characteristics, Hajj Chehade adds. Factors assessed included age at TT, sex, regimen type, RCC subtypes, IMDC risk group, prior nephrectomy, the presence of multiple metastatic sites, and hematologic toxicities such as anemia or thrombocytopenia.

Results presented at the 2024 Kidney Cancer Research Summit revealed that clear cell RCC histology was significantly associated with a higher risk of irAEs in patients with mRCC undergoing ICI combination therapy, Hajj Chehade reports.

This analysis is preliminary, further validation of the data is needed in larger cohorts. Accordingly, efforts are being made to expand and refine the cohort to provide more comprehensive data, Hajj Chehade continues.

The goal of this research is to assist clinicians in risk stratification and management of irAEs, ultimately leading to more personalized treatment approaches for mRCC patients, she adds. Understanding the risk factors for irAEs will help tailor treatments to individual patient profiles, improving outcomes and minimizing AEs, Hajj Chehade concludes.