{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T21:44:12Z","timestamp":1792532652171,"version":"4.5.0"},"reference-count":17,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Oncology"],"published-print":{"date-parts":[[2021]]},"abstract":"<b><i>Background:<\/i><\/b> The approved doses of the single agent nivolumab \u2013 an anti-programmed cell death protein 1 (PD-1) monoclonal antibody \u2013 for renal cell carcinoma (RCC) are 3 mg\/kg and a 240-mg flat dose, despite efficacy shown at lower doses in earlier CheckMate trials. In view of financial constraints, the minimum dose of nivolumab required for efficacy remains a critical area of inquiry. <b><i>Methods:<\/i><\/b> A retrospective review of RCC patients receiving single-agent anti-PD-1 treatment was conducted. Using the median cutoff of the maximum dose per body weight received, we investigated the effect of lower dosages on overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and immune-related adverse event-free survival (irAE-FS). Survival analysis was made by Kaplan-Meier, by uni- and multivariable Cox models, and by modeling the statistical interaction between dosages and survival. <b><i>Results:<\/i><\/b> 32 patients were recruited: 8 patients (25%) receiving first-line treatment and 24 (75%) receiving second-line treatment and beyond. A median split at 2.15 mg\/kg yielded 16 patients in both the lower-dose (LD) and the higher-dose (HD) cohort. Hazard ratios (HRs) demonstrated no difference in OS after adjustment for gender (HR = 0.22, 95% CI 0.05\u20131.05, <i>p<\/i> = 0.054; favoring LD), as well as in PFS after adjustment for gender and concurrent radiation therapy (HR = 0.58, 95% CI 0.25\u20131.34, <i>p<\/i> = 0.210; favoring LD). No differences in ORR were observed (50.0 vs. 43.8%, <i>p<\/i> = 1.00, in the LD and the HD cohort, respectively). Immune-related phenomena were observed in the LD group, including pseudoprogression and increased all-grade immune-related toxicities (irAE-FS: HR = 1.72, 95% CI 0.48\u20136.14, <i>p<\/i> = 0.293; favoring HD). Iterative dichotomization of dosages showed no dose-OS or dose-irAE-FS relationship. <b><i>Conclusion:<\/i><\/b> Our study suggests no apparent reduction in efficacy when using a low-dosage nivolumab regimen.<\/jats:p>","DOI":"10.1159\/000512000","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T17:01:09Z","timestamp":1610557269000},"page":"192-202","source":"Crossref","is-referenced-by-count":27,"title":["Low-Dose Nivolumab in Renal Cell Carcinoma: A Real-World Experience"],"prefix":"10.1159","volume":"99","author":[{"given":"Joseph J.","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesaretnam Barr","family":"Kumarakulasinghe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishnavi","family":"Muthu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilda","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Walsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia Li","family":"Low","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Choo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hon Lyn","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan Qin","family":"Chong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Ang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei Peng","family":"Yong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqing","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Ngoi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvin","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2021,1,13]]},"reference":[{"key":"ref1"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/69.1.239"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/81.3.515"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/asp008"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.2307\/2333709"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.2307\/2334448"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1177\/014662168300700301"},{"key":"ref8"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-019-0666-3"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1910836"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(19)30413-9"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-019-0579-z"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdy283.080"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-019-0813-8"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1112824"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2019.05.017"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.0775"}],"container-title":["Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/512000","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/512000","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T12:12:49Z","timestamp":1745410369000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000512000"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,2,26]]},"published-print":{"date-parts":[[2021,3,2]]}},"URL":"https:\/\/doi.org\/10.1159\/000512000","archive":["Portico"],"relation":{},"ISSN":["0030-2414","1423-0232"],"issn-type":[{"value":"0030-2414","type":"print"},{"value":"1423-0232","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021]]}}}