For patients with RCC who respond to PD-1 blockade, do you ever discuss stopping treatment?
If so, at what point? McDermott et al. demonstrated some lasting responses after discontinuation of therapy (JCO 2015), but these responses are still unpredictable.
Answer from: Medical Oncologist at Academic Institution
It has only been a year since nivolumab was approved for the treatment of metastatic renal cell carcinoma (mRCC). In the absence of long term follow up data, especially in the real world setting, it is difficult to conclude whether stopping treatment with nivolumab in responding patients is appropri...
Answer from: Medical Oncologist at Academic Institution
This is a reasonable approach by @Neeraj Agarwal; agree that data is really very limited and hard to know the answer. It also depends on benefits vs risks (e.g. toxicity). Would also add the importance to conduct relevant clinical trials to answer the question based on more data.
This is a great question.
I agree with @Neeraj Agarwal's approach though I caution that there is no Level 1 prospective data to directly answer this question.
Here's how I approach it with my patients: If they are tolerating therapy well without any significant adverse events, my preference is to ...
Answer from: Medical Oncologist at Academic Institution
There is no mature data for metastatic renal cell carcinoma in this space. Melanoma and NSCLung ca are likely to have some data emerging for this question. Hypothetically, if I had a patient who experienced a complete response (rare) to immune checkpoint therapy, I might consider observing off treat...