Evolving landscape of first-line combination therapy in advanced renal cancer: a systematic review

被引：25

作者：

Lalani, Aly-Khan A. ^{[1
]}

Heng, Daniel Y. C. ^{[2
]}

Basappa, Naveen S. ^{[3
]}

Wood, Lori ^{[4
]}

Iqbal, Nayyer ^{[5
]}

McLeod, Deanna ^{[6
]}

Soulieres, Denis ^{[7
]}

Kollmannsberger, Christian ^{[8
]}

机构：

[1] McMaster Univ, Juravinski Canc Ctr, Div Med Oncol, 699 Concess St, Hamilton, ON L8V5C2, Canada

[2] Univ Calgary, Tom Baker Canc Ctr, Calgary, AB, Canada

[3] Cross Canc Inst, Edmonton, AB, Canada

[4] Queen Elizabeth 2 Hlth Sci Ctr, Halifax, NS, Canada

[5] Saskatoon Canc Ctr, Saskatoon, SK, Canada

[6] Kaleidoscope Strateg Inc, Toronto, ON, Canada

[7] Ctr Hosp Univ Montreal, Montreal, PQ, Canada

[8] BC Canc, Med Oncol, Vancouver, BC, Canada

来源：

THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY | 2022年 / 14卷

关键词：

advanced disease; combination therapy; immune checkpoint inhibitors; metastatic or locally targeted therapy; renal carcinoma; tyrosine kinase inhibitors; NIVOLUMAB PLUS IPILIMUMAB; CELL CARCINOMA ARCC; OPEN-LABEL; SUBSEQUENT THERAPY; SURVIVAL OUTCOMES; FOLLOW-UP; SUNITINIB; AXITINIB; EVEROLIMUS; TRIAL;

D O I：

10.1177/17588359221108685

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Renal cell carcinoma (RCC) is a common malignancy with approximately 30% of cases diagnosed at the advanced or metastatic stage. While single-agent vascular endothelial growth factor-targeted therapy has been a mainstay of treatment, data from multiple phase III trials assessing first-line immune checkpoint inhibitor (ICI) combinations have demonstrated a significant survival benefit. Methods: A systematic search of the published and presented literature was performed to identify phase III trials assessing ICI combination regimens in RCC using search terms 'immune checkpoint inhibitors' AND 'renal cell carcinoma,' AND 'advanced'. Results: Six phase III trials showed significant benefits for ICI combinations compared with sunitinib. Nivolumab plus ipilimumab significantly improved overall survival [OS; median, 47.0 versus 26.6 months, hazard ratio (HR) = 0.68, 95% confidence interval (CI) = 0.58-0.81, p < 0.0001) and progression-free survival (PFS; median 11.6 versus 8.3 months, HR = 0.73, 95% CI = 0.61-0.87, p = 0.0004) in International Metastatic renal cell carcinoma Database Consortium intermediate and poor-risk patients. OS was also significantly improved for ICI plus tyrosine kinase inhibitor combinations regardless of risk, including pembrolizumab plus either axitinib (HR = 0.73, 95% CI = 0.60-0.88, p < 0.001) or lenvatinib (HR = 0.66, 95% CI = 0.49-0.88, p = 0.005) and nivolumab plus cabozantinib (HR = 0.66, 95% CI = 0.50-0.87, p = 0.003). No new safety signals were identified. Conclusions: Phase III first-line trials of ICI combinations showed survival benefits compared with a control arm of sunitinib. Global access to these combinations should be made available to patients with advanced RCC.

引用

页数：17

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