Retrospective cohort study of association of serum sodium levels with outcomes of nivolumab for metastatic renal cell carcinoma

Low serum sodium levels have been associated with adverse outcomes among patients with metastatic renal cell carcinoma (mRCC) receiving therapies other than immune checkpoint inhibitors. A multicenter retrospective cohort study in Italy (355 patients) investigated association of serum sodium levels (<140 versus ≥ 140 mEq/l) with outcomes of mRCC patients receiving second-line nivolumab (3 mg/kg every 2 weeks or fixed dose 240 mg every 2 weeks or 480 mg every 4 weeks). This figure shows that patients with both pre-nivolumab and post-nivolumab serum sodium ≥ 140 mEq/l had significantly improved PFS (median 11,5 months versus 5,8 months; p=0.008) and OS (median 37.6 months versus 19.4 months; p=0.01) compared with those with pre- and post-nivolumab levels < 140 mEq/l. The authors conclude that these findings suggest that serum sodium levels may be associated with survival outcomes in patients with mRCC receiving nivolumab.