Prognostic value of type of prior TKI in pretreated metastatic renal cell carcinoma patients receiving nivolumab

被引：0

作者：

Damassi, Alessandra ^{[1
]}

Cremante, Malvina ^{[1
]}

Signori, Alessio ^{[2
]}

Rebuzzi, Sara Elena ^{[3
,4
]}

Malgeri, Andrea ^{[5
]}

Napoli, Marilena Di ^{[6
]}

Caffo, Orazio ^{[7
]}

Vignani, Francesca ^{[8
]}

Cavo, Alessia ^{[9
]}

Roviello, Giandomenico ^{[10
]}

Prati, Veronica ^{[11
]}

Tudini, Marianna ^{[12
]}

Atzori, Francesco ^{[13
]}

Messina, Marco ^{[14
]}

Morelli, Franco ^{[15
]}

Prati, Giuseppe ^{[16
]}

Nole, Franco ^{[17
]}

Catalano, Fabio ^{[1
]}

Murianni, Veronica ^{[1
]}

Rescigno, Pasquale ^{[18
,19
]}

Banna, Giuseppe Luigi ^{[20
,21
]}

Fornarini, Giuseppe ^{[1
]}

Buti, Sebastiano ^{[22
,23
]}

机构：

[1] IRCCS Osped Policlin San Martino, Med Oncol Unit 1, I-16132 Genoa, Italy

[2] Univ Genoa, Dept Hlth Sci DISSAL, Sect Biostat, I-16132 Genoa, Italy

[3] Osped San Paolo, Med Oncol Unit, I-17100 Savona, Italy

[4] Univ Genoa, Dept Internal Md & Med Specialties Di M I, I-16132 Genoa, Italy

[5] Univ Campus Biomed Roma, Dept Med Oncol, I-00128 Rome, Italy

[6] Ist Ricovero & Cura Carattere Sci IRCCS Fdn G Pasc, Ist Nazl Tumori, Dept Urol & Gynecol, I-80131 Naples, Italy

[7] Osped Santa Chiara APSS, Med Oncol Dept, I-38122 Trento, Italy

[8] Ordine Mauriziano Hosp, Div Med Oncol, I-10128 Turin, Italy

[9] Villa Scassi Hosp, Oncol Unit, I-16149 Genoa, Italy

[10] Univ Firenze, Dept Hlth Sci, Sect Clin Pharmacol & Oncol, I-50139 Florence, Italy

[11] Osped Michele & Pietro Ferrero, Dept Med Oncol, Verduno Azienda Sanit Locale CN2, I-12060 Verduno, Italy

[12] St Salvatore Hosp, Med Oncol, I-67100 Laquila, Italy

[13] ASL Sulcis, Osped Sirai Carbonia, SSD Oncol Med, Sirai, Italy

[14] Osped Civ ARNAS, Med Oncol, I-90127 Palermo, Italy

[15] IRCCS Casa Sollievo Sofferenza, Oncol Dept, I-71013 San Giovanni Rotondo, Italy

[16] IRCCS AUSL Reggio Emilia, Dept Oncol & Adv Technol, I-41016 Guastalla, Italy

[17] European Inst Oncol IRCCS, Med Oncol Div Urogenital & Head & Neck Tumors, IEO, I-20141 Milan, Italy

[18] Newcastle Univ, Translat & Clin Res Inst, Ctr Canc, Newcastle Upon Tyne NE7 7DN, England

[19] FPO IRCCS, Candiolo Canc Inst, I-10060 Candiolo, Italy

[20] Portsmouth Hosp Univ NHS Trust, Portsmouth PO6 3LY, England

[21] Univ Portsmouth, Fac Sci & Hlth, Sch Pharm & Biomed Sci, Portsmouth PO1 2UP, England

[22] Univ Hosp Parma, Med Oncol Unit, I-43126 Parma, Italy

[23] Univ Parma, Dept Med & Surg, I-43121 Parma, Italy

来源：

IMMUNOTHERAPY | 2024年

关键词：

IMDC score; meet-URO score; metastatic renal cell carcinoma; nivolumab; treatment sequence; tyrosine kinase inhibitor; SUNITINIB;

D O I：

10.1080/1750743X.2024.2385881

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Aim: To define the prognostic significance of first-line TKI in mRCC patients receiving nivolumab.Materials and methods: A total of 571 mRCC patients who received >= second line nivolumab were included in this subanalysis. The correlation between prior TKI (sunitinib vs. pazopanib) and overall response rate (ORR), disease control rate, progression-free survival and overall survival were investigated. Additionally, the impact of TKI choice according to the International Metastatic RCC Database Consortium prognostic score was examined.Results: There was no significant difference between sunitinib and pazopanib groups in terms of mPFS, mOS, overall response rate and disease control rate. Moreover, no difference between sunitinib and pazopanib was found according to the International Metastatic RCC Database Consortium prognostic score.Conclusion: There is no conclusive evidence favoring pazopanib or sunitinib treatment before initiating nivolumab therapy in metastatic renal cell carcinoma patients. <boxed-text id="BT0001"><caption>Article highlights</caption>IntroductionTKI monotherapy is still an option for mRCC patients<list list-type="bullet"><list-item>Despite the success of immune-checkpoint inhibitors, TKI monotherapy remains an option for selected mRCC patients, particularly those with favorable-risk IMDC status or those unsuitable for immunotherapy.</list-item><list-item>In vitro studies have indicated that pazopanib exhibits stronger immunomodulatory activity compared with sunitinib.</list-item><list-item>In clinical practice there are no established criteria for selecting the first-line TKI and the optimal treatment sequence remains uncertain.</list-item></list>Material & methods<list list-type="bullet"><list-item>This study included patients with mRCC who had progressed after prior treatment with sunitinib or pazopanib and received 2nd or further line nivolumab in a real-world setting.</list-item><list-item>This subanalysis of the Meet-URO 15 study aims to investigate survival (OS, PFS) and response outcomes (ORR, DCR).</list-item></list>Results<list list-type="bullet"><list-item>There was no significant difference between previous sunitinib or pazopanib in terms of mPFS, mOS, ORR and DCR.</list-item><list-item>No difference between previous sunitinib and pazopanib was found according to the IMDC prognostic score.</list-item><list-item>There is no conclusive evidence favoring pazopanib or sunitinib treatment before initiating nivolumab therapy in mRCC patients.</list-item></list>DiscussionFuture challenges<list list-type="bullet"><list-item>Understanding the interactions between immunotherapy, the immune system, and specific types of TKIs remains a relevant topic in both clinical trials and clinical practice.</list-item><list-item>More evidence is needed to better understand the differences among currently available immuno-combinations.</list-item><list-item>Further studies are necessary to gain a better understanding of the optimal treatment selection and sequence.</list-item></list></sec></boxed-text>

引用

页数：9

共 35 条

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