TY - JOUR AU - Grimm, Marc-Oliver AU - Esteban, Emilio AU - Barthélémy, Philippe AU - Schmidinger, Manuela AU - Busch, Jonas AU - Valderrama, Begoña P AU - Charnley, Natalie AU - Schmitz, Marc AU - Schumacher, Ulrike AU - Leucht, Katharina AU - Foller, Susan AU - Baretton, Gustavo AU - Duran, Ignacio AU - de Velasco, Guillermo AU - Priou, Frank AU - Maroto, Pablo AU - Albiges, Laurence TI - Tailored immunotherapy approach with nivolumab with or without nivolumab plus ipilimumab as immunotherapeutic boost in patients with metastatic renal cell carcinoma (TITAN-RCC): a multicentre, single-arm, phase 2 trial. JO - The lancet / Oncology VL - 24 IS - 11 SN - 1470-2045 CY - London PB - The Lancet Publ. Group M1 - DKFZ-2023-02099 SP - 1252-1265 PY - 2023 N1 - 2023 Nov;24(11):1252-1265 AB - Nivolumab plus ipilimumab is approved as first-line regimen for intermediate-risk or poor-risk metastatic renal cell carcinoma, and nivolumab monotherapy as second-line therapy for all risk groups. We aimed to examine the efficacy and safety of nivolumab monotherapy and nivolumab plus ipilimumab combination as an immunotherapeutic boost after no response to nivolumab monotherapy in patients with intermediate-risk and poor-risk clear-cell metastatic renal cell carcinoma.TITAN-RCC is a multicentre, single-arm, phase 2 trial, done at 28 hospitals and cancer centres across Europe (Austria, Belgium, Czech Republic, France, Germany, Italy, Spain, and the UK). Adults (aged ≥18 years) with histologically confirmed intermediate-risk or poor-risk clear-cell metastatic renal cell carcinoma who were formerly untreated (first-line population) or pretreated with one previous systemic therapy (anti-angiogenic or temsirolimus; second-line population) were eligible. Patients had to have a Karnofsky Performance Status score of at least 70 and measurable disease per Response Evaluation Criteria in Solid Tumours (version 1.1). Patients started with intravenous nivolumab 240 mg once every 2 weeks. On early progressive disease (week 8) or non-response at week 16, patients received two or four doses of intravenous nivolumab (3 mg/kg) and ipilimumab (1 mg/kg) boosts (once every 3 weeks), whereas responders continued with intravenous nivolumab (240 mg, once every 2 weeks), but could receive two to four boost doses of nivolumab plus ipilimumab for subsequent progressive disease. The primary endpoint was confirmed investigator-assessed objective response rate in the full analysis set, which included all patients who received at least one dose of study medication; safety was also assessed in this population. An objective response rate of more than 25 LB - PUB:(DE-HGF)16 C6 - pmid:37844597 DO - DOI:10.1016/S1470-2045(23)00449-7 UR - https://inrepo02.dkfz.de/record/284788 ER -