Real-world outcomes of nivolumab plus ipilimumab versus immune checkpoint inhibitor and tyrosine kinase inhibitor combinations as first-line treatment for metastatic clear cell renal cell carcinoma.
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Le résumé fourni par la source
e16510 Background: The management of metastatic clear cell renal cell carcinoma (mccRCC) has evolved significantly with the introduction of immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs). However, limited real-world data exist comparing the efficacy of nivolumab plus ipilimumab (N/I) with ICI plus TKI (IO/TKI) combinations. This study evaluates progression-free survival (PFS), overall survival (OS), and other efficacy parameters for these regimens in patients with mccRCC treated at tertiary care centers in Saudi Arabia. Methods: This retrospective, multicenter study included patients with mccRCC treated with first-line N/I or IO/TKI between 2018 and 2022. Eligible patients had confirmed clear cell histology, were treatment-naïve, and received first-line ICIs. Patient demographics, IMDC risk groups, treatment regimens, and efficacy outcomes were analyzed. PFS and OS were calculated using Kaplan-Meier estimates. Univariate and multivariate analyses were performed to identify factors affecting outcomes. Results: A total of 99 patients were included, with 33 receiving N/I and 66 receiving IO/TKI. Patients in the IO/TKI group had a higher proportion of Furhman grade 3–4 tumors (47% vs. 30%) and prior nephrectomy (53% vs. 39%), while more patients in the N/I group presented with N1 disease (33% vs. 17%) and de novo metastatic disease (82% vs. 68%). Median PFS for the overall cohort was 16 months (95% CI: 12.6-19.4); PFS was significantly longer in the IO/TKI group (21.36 months, 95% CI: 13.08–29.63) compared to the N/I group (10.49 months, 95% CI: 1.60–19.29; p = 0.03). OS was not reached in either group, with 3-year OS rates of 57% (95% CI: 34–74%) for N/I and 67% (95% CI: 19–77%) for IO/TKI (p = 0.2). Multivariate analysis showed that IO/TKI use (p = 0.03) and lymphocyte-to-platelet (L/P) ratio > 6.14 (p = 0.003) were independently associated with improved PFS, while pure clear cell histology (p = 0.04), L/P ratio > 6.14 (p = 0.006), and absence of bone metastasis (p = 0.02) were associated with improved OS. Conclusions: In this real-world analysis, IO/TKI combinations demonstrated significantly longer PFS compared to N/I, with comparable OS outcomes. The findings highlight the importance of individualized treatment selection based on patient characteristics, including disease presentation, risk stratification, and tumor features.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Real-world outcomes of nivolumab plus ipilimumab versus immune checkpoint inhibitor and tyrosine kinase inhibitor combinations as first-line treatment for metastatic clear cell renal cell carcinoma.
- Date Crossref
- 01/06/2025
- Éditeur
- American Society of Clinical Oncology (ASCO)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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King Fahad Specialist Hospital pays non établi dans la noticeÉtablissement de santé
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King Abdulaziz Medical City pays non établi dans la noticeÉtablissement de santé
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King Fahd Medical City pays non établi dans la noticeOrganisme public
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Security Forces Hospital Department of Internal Medicine pays non établi dans la noticeÉtablissement de santé
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King Faisal Specialist Hospital & Research Centre pays non établi dans la noticeÉtablissement de santé
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Alfaisal University pays non établi dans la noticeUniversité ou école supérieure
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King Fahad Medical City pays non établi dans la noticeInstitution
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King Faisal Specialist Hospital and Research Center Cancer Center of Excellence pays non établi dans la noticeStructure de recherche
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King Faisal Specialist Hospital and Research Centre Department of Medical Oncology pays non établi dans la noticeStructure de recherche
King Fahad Specialist Hospital, King Abdulaziz Medical City et King Fahd Medical City, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.