Can Cytoreductive Nephrectomy Improve Outcomes of Nivolumab Treatment in Patients with Metastatic Clear-Cell Renal Carcinoma?

被引：0

作者：

Ocak, Birol ^{[1
]}

Sahin, Ahmet Bilgehan ^{[2
]}

Erturk, Ismail ^{[3
]}

Korkmaz, Mustafa ^{[4
]}

Erdem, Dilek ^{[5
]}

Cakiroglu, Umut ^{[6
]}

Karaca, Mustafa ^{[7
]}

Dirican, Ahmet ^{[8
]}

Olmez, Omer Fatih ^{[9
]}

Goktas Aydin, Sabin ^{[9
]}

Gokyer, Ali ^{[10
]}

Kucukarda, Ahmet ^{[10
]}

Gulmez, Ahmet ^{[11
]}

Yumuk, Perran Fulden ^{[12
]}

Demircan, Nazim Can ^{[12
]}

Oyman, Abdilkerim ^{[13
]}

Sakalar, Teoman ^{[14
]}

Karatas, Fatih ^{[15
]}

Demir, Hacer ^{[16
]}

Yasin, Ayse Irem ^{[17
]}

Deligonul, Adem ^{[2
]}

Dakiki, Bahar ^{[2
]}

Goktug, Mehmet Refik ^{[2
]}

Avci, Okan ^{[18
]}

Tacar, Seher Yildiz ^{[18
]}

Turhal, Nazim Serdar ^{[19
]}

Deniz, Guelhan Ipek ^{[20
]}

Kacan, Turgut ^{[1
]}

Cubukcu, Erdem ^{[2
]}

Evrensel, Tuerkkan ^{[2
]}

机构：

[1] Univ Hlth Sci, Bursa Yuksek Ihtisas Training & Res Hosp, Dept Med Genet, TR-16350 Bursa, Turkiye

[2] Bursa Uludag Univ, Sch Med, Dept Med Oncol, TR-16059 Bursa, Turkiye

[3] Univ Hlth Sci, Gulhane Sch Med, Dept Med Oncol, TR-06018 Ankara, Turkiye

[4] Necmettin Erbakan Univ, Sch Med, Dept Med Oncol, TR-42090 Konya, Turkiye

[5] VM Med Pk Samsun Hosp, Dept Med Oncol, TR-55200 Samsun, Turkiye

[6] Univ Hlth Sci, Van Training & Res Hosp, Dept Med Oncol, TR-65300 Van, Turkiye

[7] Univ Hlth Sci, Antalya Training & Res Hosp, Dept Med Oncol, TR-07100 Antalya, Turkiye

[8] Celal Bayar Univ, Sch Med, Dept Med Oncol, TR-45140 Manisa, Turkiye

[9] Medipol Univ Hosp, Dept Med Oncol, TR-34810 Istanbul, Turkiye

[10] Trakya Univ, Div Med Oncol, Dept Internal Med, Sch Med, TR-22130 Edirne, Turkiye

[11] Inonu Univ, Sch Med, Dept Med Oncol, TR-44280 Malatya, Turkiye

[12] Marmara Univ, Sch Med, Dept Med Oncol, TR-34854 Istanbul, Turkiye

[13] Univ Hlth Sci, Umraniye Training & Res Hosp, Dept Med Oncol, TR-34764 Istanbul, Turkiye

[14] Necip Fazil City Hosp, Dept Med Oncol, TR-46050 Kahramanmaras, Turkiye

[15] Karabuk Univ, Fac Med, Dept Med Microbiol, TR-78100 Karabuk, Turkiye

[16] Afyonkarahisar Hlth Sci Univ, Fac Med, Dept Radiat Oncol, TR-03030 Afyon, Turkiye

[17] Bezmialem Vakif Univ, Fac Med, Dept Med Oncol, Istanbul, Turkiye

[18] Tekirdag Namik Kemal Univ, Dept Med Oncol, TR-34093 Tekirdag, Turkiye

[19] Anadolu Hlth Ctr, Dept Med Oncol, TR-2255 Kocaeli, Turkiye

[20] Univ Hlth Sci, Sisli Hamidiye Etfal Training & Res Hosp, Dept Med Oncol, TR-34371 Istanbul, Turkiye

来源：

CURRENT ONCOLOGY | 2024年 / 31卷 / 09期

关键词：

clear-cell renal-cell carcinoma; cytoreductive nephrectomy; nivolumab; survival; IMMUNOTHERAPY; CRITERIA; THERAPY;

D O I：

10.3390/curroncol31090384

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: This study aimed to investigate the effect of cytoreductive nephrectomy (CN) on the survival outcomes of nivolumab used as a subsequent therapy after the failure of at least one anti-vascular endothelial growth factor (VEGF) agent in patients with metastatic clear-cell renal-cell carcinoma (ccRCC). Methods: We included 106 de novo metastatic ccRCC patients who received nivolumab after progression on at least one anti-VEGF agent. Multivariate Cox regression analysis was performed to investigate the factors affecting survival in patients receiving nivolumab. Results: Of the 106 de novo metastatic ccRCC patients, 83 (78.3%) underwent CN. There were no statistical differences between the two groups in terms of age, gender, Eastern Cooperative Oncology Group (ECOG) score, tumor size, International Metastatic RCC Database Consortium (IMDC) risk group, number of previous treatment lines, first-line anti-VEGF therapy, or metastasis sites (p = 0.137, p = 0.608, p = 0.100, p = 0.376, p = 0.185, p = 0.776, p = 0.350, and p = 0.608, respectively). The patients who received nivolumab with CN had a longer time to treatment discontinuation (TTD) [14.5 months, 95% confidence interval (CI): 8.6-20.3] than did those without CN 6.7 months (95% CI: 3.9-9.5) (p = 0.001). The median overall survival (OS) was 22.7 months (95% CI: 16.1-29.4). The patients with CN had a median OS of 22.9 months (95% CI: 16.3-29.4), while those without CN had a median OS of 8.1 months (95% CI: 5.6-10.5) (p = 0.104). In the multivariate analysis, CN [hazard ratio (HR): 0.521; 95% CI: 0.297-0.916; p = 0.024] and the IMDC risk score (p = 0.011) were statistically significant factors affecting TTD; however, the IMDC risk score (p = 0.006) was the only significant factor for overall survival. Conclusions: Our study showed that the TTD of nivolumab was longer in metastatic ccRCC patients who underwent cytoreductive nephrectomy.

引用

页码：5195 / 5205

页数：11

共 35 条

[1] Nivolumab plus ipilimumab versus sunitinib for first-line treatment of advanced renal cell carcinoma: extended 4-year follow-up of the phase III CheckMate 214 trial [J].

Albiges, Laurence ;

Tannir, Nizar M. ;

Burotto, Mauricio ;

McDermott, David ;

Plimack, Elizabeth R. ;

Barthelemy, Philippe ;

Porta, Camillo ;

Powles, Thomas ;

Donskov, Frede ;

George, Saby ;

Kollmannsberger, Christian K. ;

Gurney, Howard ;

Grimm, Marc-Oliver ;

Tomita, Yoshihiko ;

Castellano, Daniel ;

Rini, Brian, I ;

Choueiri, Toni K. ;

Saggi, Shruti Shally ;

McHenry, M. Brent ;

Motzer, Robert J. .

ESMO OPEN, 2020, 5 (06)

[2] Ecology meets cancer biology: The cancer swamp promotes the lethal cancer phenotype [J].

Amend, Sarah R. ;

Pienta, Kenneth J. .

ONCOTARGET, 2015, 6 (12) :9669-9678

[3] Analysis of time-to-treatment discontinuation of targeted therapy, immunotherapy, and chemotherapy in clinical trials of patients with non-small-cell lung cancer [J].

Blumenthal, G. M. ;

Gong, Y. ;

Kehl, K. ;

Mishra-Kalyani, P. ;

Goldberg, K. B. ;

Khozin, S. ;

Kluetz, P. G. ;

Oxnard, G. R. ;

Pazdur, R. .

ANNALS OF ONCOLOGY, 2019, 30 (05) :830-838

[4]

Choueiri TK, 2020, ANN ONCOL, V31, P1030, DOI [10.1016/j.annonc.2020.04.010, 10.1016/j.annoc.2020.04.010]

[5] Follow-up after curative treatment of localised renal cell carcinoma [J].

Dabestani, Saeed ;

Marconi, Lorenzo ;

Kuusk, Teele ;

Bex, Axel .

WORLD JOURNAL OF UROLOGY, 2018, 36 (12) :1953-1959

[6] New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1) [J].

Eisenhauer, E. A. ;

Therasse, P. ;

Bogaerts, J. ;

Schwartz, L. H. ;

Sargent, D. ;

Ford, R. ;

Dancey, J. ;

Arbuck, S. ;

Gwyther, S. ;

Mooney, M. ;

Rubinstein, L. ;

Shankar, L. ;

Dodd, L. ;

Kaplan, R. ;

Lacombe, D. ;

Verweij, J. .

EUROPEAN JOURNAL OF CANCER, 2009, 45 (02) :228-247

[7] Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up [J].

Escudier, B. ;

Porta, C. ;

Schmidinger, M. ;

Rioux-Leclercq, N. ;

Bex, A. ;

Khoo, V. ;

Grunwald, V. ;

Gillessen, S. ;

Horwich, A. .

ANNALS OF ONCOLOGY, 2019, 30 (05) :706-720

[8]

Fallah J., 2021, J. Clin. Oncol, V39, P15, DOI [10.1200/JCO.2021.39.15suppl.4516, DOI 10.1200/JCO.2021.39.15SUPPL.4516]

[9] Current and future systemic treatments for renal cell carcinoma [J].

Fisher, Rosalie ;

Gore, Martin ;

Larkin, James .

SEMINARS IN CANCER BIOLOGY, 2013, 23 (01) :38-45

[10] Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer [J].

Flanigan, RC ;

Salmon, SE ;

Blumenstein, BA ;

Bearman, SI ;

Roy, V ;

McGrath, PC ;

Caton, JR ;

Munshi, N ;

Crawford, ED .

NEW ENGLAND JOURNAL OF MEDICINE, 2001, 345 (23) :1655-1659

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