Dr Ramnaraign on Retrospective Data For irAEs in Older Patients With Kidney Cancer

Brian H. Ramnaraign, MD, assistant professor of medicine, Division of Hematology and Oncology, the University of Florida (UF) College of Medicine, UF Health, discusses findings from a single-institution review of the incidence of immunotherapy-related toxicities in older patients with kidney cancer.

At the 2023 International Kidney Cancer Symposium, Ramnaraign shared data from a retrospective study conducted at UF Health Cancer Center between January 2018 and September 2022. This investigation focused on the safety of immune checkpoint inhibitors in older patients with kidney cancer, and of the 58 patients included, the median age was 71 years (range, 65-92). Findings shared during the meeting showed that 57% of patients experienced immune-related adverse effects (irAEs). In patients where irAEs occurred, 15% were grade 1, 52% were grade 2, 30% were grade 3, and 3% were grade 4. Notably, no grade 5 irAEs were reported.

Additionally, 28% of all patients required steroids for the management of irAEs. These toxicities led treatment discontinuation in 12% of patients, and another 12% of patients had inpatient hospitalization due to irAEs. Overall, findings from the retrospective study suggest that immune checkpoint inhibitors are generally safe in older patients with kidney cancer, with low rates of serious irAEs, steroid use, hospitalization, and treatment discontinuation.

Ramnaraign highlgihts that this investigation focused on real-world outcomes for individuals aged 65 and above with kidney cancer who underwent treatment with these immune checkpoint inhibitors. He also highlighted that the motivation for this investigation stemmed from the underrepresentation of older patients in clinical trials, often due to factors such as polypharmacy, comorbidities, and age-related exclusion criteria.

To assess the safety data in these real-world scenarios, Ramnaraign says that he and investigators gathered information from their institution. Notably, the majority of these patients tolerated the treatment well, he emphasizes. The study indicates that most patients could continue treatment despite toxicity, with a minimal need for hospitalization or steroid use, Ramnaraign concludes.