What is your experience with comparative toxicities of the available 1L combination regimens in metastatic ccRCC?
Do you select treatment based on toxicity profile since efficacy of regimens will likely never be directly compared?
Are there QOL indices that can inform discussions with patients?
Answer from: Medical Oncologist at Academic Institution
Toxicity profile is very important in choosing a regimen, noting that no direct comparisons exist. Ipi/nivo is characterized by more initial, inflammatory toxicity, but relatively well tolerated nivo monotherapy maintenance and the ability to be off all therapy for a subset of patients. IO/TKI combo...
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Answer from: Medical Oncologist at Academic Institution
Toxicity profile certainly plays a role in therapeutic choice. The combination of ipi and nivo for intermediate and poor risk disease has proven survival benefit and has only immune related adverse events. However, for elderly patients or patients with less reserve, the tolerability of this combinat...
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Medical Oncologist at Wenatchee Valley Med Center
I think a lot of patients don't tolerate the TKI's...
I think a lot of patients don't tolerate the TKI's...
Answer from: Medical Oncologist at Academic Institution
The combination of nivolumab and ipilimumab has the highest rate of irAE with >30% requiring high dose steroids (> 40 mg prednisone daily or equivalent) with the need for close monitoring, particularly in the first 6 months, for clinically significant irAE. However, after the first 6 months, w...