Severe Immune-Related Adverse Events in Patients Treated with Nivolumab for Metastatic Renal Cell Carcinoma Are Associated with PDCD1 Polymorphism

Abstract

Single nucleotide polymorphisms (SNPs) reportedly influence the effect of nivolumab in metastatic renal cell carcinoma (mRCC). This study aimed to evaluate the relationship between the clinical outcomes of patients with mRCC and SNPs in programmed cell death protein 1 (PD-1) protein-coding gene (<i>PDCD1</i>) and explore any potential correlation with patient prognosis and incidence of immune-related adverse events (irAEs). In total, 106 patients with mRCC, who were treated with nivolumab alone (<i>n</i> = 59) or nivolumab and ipilimumab (<i>n</i> = 47), were enrolled in the study. Three SNPs in the <i>PDCD1</i> gene, namely <i>PD-1.3</i>, <i>PD-1.5</i>, and <i>PD-1.6</i>, were assessed. Patients harboring the <i>PD-1.6 G</i> allele experienced more severe (odds ratio, 3.390; 95% confidence interval 1.517-7.756; <i>p</i> = 0.003) and multiple (OR, 2.778; 95% CI, 1.020-6.993 <i>p</i> = 0.031) irAEs than those harboring the <i>AA</i> genotype. Thus, the existence of the <i>PDCD1 PD-1.6</i> polymorphism (<i>G</i> allele) was associated with the occurrence of severe and multiple irAEs in patients with mRCC. Further evaluation of <i>PDCD1</i> polymorphisms might help identify patients experiencing irAE by nivolumab treatment.