Immunotherapy in Dialysis-Dependent Cancer Patients: Our Experience in Patients With Metastatic Renal Cell Carcinoma and a Review of the Literature

In the past few years, several new drugs such as targeted therapy and immunotherapy have shown activity for the treatment of metastatic renal cell carcinoma (mRCC).Literature data are very limited in some subgroups of patients such as those with end-stage renal disease who require hemodialysis and were excluded from pivotal clinical trials.We retrospectively reviewed the medical records of 8 hemodialysis-dependent patients with mRCC who were treated with nivolumab to evaluate the treatment-related toxicities and the clinical outcomes.Among these 8 patients, the objective response rate was 12.5%, and the disease control rate was 75%. The estimated median progression-free survival was 16 months and median overall survival was 26 months. There were no Grade 4 adverse events and only 2 patients had Grade 3 adverse events.Despite that the retrospective nature of this survey and the relatively small sample size represent major limitations, these data indicate that treatment with nivolumab is feasible with no unexpected toxicity and good efficacy in this cohort of patients.These results merit further confirmation in a larger prospective trial. (C) 2019 Elsevier Inc. All rights reserved.