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Real-World Impact of Upfront Cytoreductive Nephrectomy in Metastatic Non-Clear Cell Renal Cell Carcinoma Treated with First-Line Immunotherapy Combinations or Tyrosine Kinase Inhibitors (A Sub-Analysis from the ARON-1 Retrospective Study)
O. Fiala, S. Buti, A. Bamias, F. Massari, R. Pichler, M. Maruzzo, E. Grande, U. De Giorgi, J. Molina-Cerrillo, E. Seront, F. Calabrò, ZW. Myint, G. Facchini, RM. Kopp, R. Berardi, J. Kucharz, MG. Vitale, A. Pinto, L. Formisano, T. Büttner, C....
Jazyk angličtina Země Francie
Typ dokumentu časopisecké články
NLK
ProQuest Central
od 2006-01-01 do Před 1 rokem
Medline Complete (EBSCOhost)
od 2006-01-01 do Před 1 rokem
Nursing & Allied Health Database (ProQuest)
od 2006-01-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 2006-01-01 do Před 1 rokem
Family Health Database (ProQuest)
od 2006-01-01 do Před 1 rokem
- MeSH
- cytoredukční chirurgie * metody MeSH
- dospělí MeSH
- imunoterapie * metody MeSH
- inhibitory proteinkinas * terapeutické užití farmakologie MeSH
- inhibitory tyrosinkinasy MeSH
- karcinom z renálních buněk * farmakoterapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- metastázy nádorů MeSH
- nádory ledvin * farmakoterapie patologie MeSH
- nefrektomie * metody MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: About 20% of patients with renal cell carcinoma present with non-clear cell histology (nccRCC), encompassing various histological types. While surgery remains pivotal for localized-stage nccRCC, the role of cytoreductive nephrectomy (CN) in metastatic nccRCC is contentious. Limited data exist on the role of CN in metastatic nccRCC under current standard of care. OBJECTIVE: This retrospective study focused on the impact of upfront CN on metastatic nccRCC outcomes with first-line immune checkpoint inhibitor (IO) combinations or tyrosine kinase inhibitor (TKI) monotherapy. METHODS: The study included 221 patients with nccRCC and synchronous metastatic disease, treated with IO combinations or TKI monotherapy in the first line. Baseline clinical characteristics, systemic therapy, and treatment outcomes were analyzed. The primary objective was to assess clinical outcomes, including progression-free survival (PFS) and overall survival (OS). Statistical analysis involved the Fisher exact test, Pearson's correlation coefficient, analysis of variance, Kaplan-Meier method, log-rank test, and univariate/multivariate Cox proportional hazard regression models. RESULTS: Median OS for patients undergoing upfront CN was 36.8 (95% confidence interval [CI] 24.9-71.3) versus 20.8 (95% CI 12.6-24.8) months for those without CN (p = 0.005). Upfront CN was significantly associated with OS in the multivariate Cox regression analysis (hazard ratio 0.47 [95% CI 0.31-0.72], p < 0.001). In patients without CN, the median OS and PFS was 24.5 (95% CI 18.1-40.5) and 13.0 months (95% CI 6.6-23.5) for patients treated with IO+TKI versus 7.5 (95% CI 4.3-22.4) and 4.9 months (95% CI 3.0-8.1) for those receiving the IO+IO combination (p = 0.059 and p = 0.032, respectively). CONCLUSIONS: Our study demonstrates the survival benefits of upfront CN compared with systemic therapy without CN. The study suggests that the use of IO+TKI combination or, eventually, TKI monotherapy might be a better choice than IO+IO combination for patients who are not candidates for CN regardless of IO eligibility. Prospective trials are needed to validate these findings and refine the role of CN in current mRCC management.
Clinical Oncology Sociedad de Oncología y Hematología del Cesar Valledupar Colombia
Department of Medical and Surgical Sciences University of Bologna Bologna Italy
Department of Medical Oncology Hospital Ramón y Cajal Madrid Spain
Department of Medical Oncology Università Politecnica delle Marche AOU delle Marche Ancona Italy
Department of Medicine and Surgery Federico 2 University Naples Italy
Department of Medicine and Surgery University of Parma Via Gramsci 14 43126 Parma Italy
Department of Urology Medical University of Innsbruck Anichstrasse 35 6020 Innsbruck Austria
Department of Urology University Hospital Bonn 53127 Bonn Germany
Markey Cancer Center University of Kentucky Lexington KY 40536 0293 USA
Medical Oncology 1 IRCCS Regina Elena National Cancer Institute Rome Italy
Medical Oncology Department La Paz University Hospital Madrid Spain
Medical Oncology IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna Italy
National Cancer Centre Singapore Singapore
Oncology 1 Unit Department of Oncology Istituto Oncologico Veneto IOV IRCCS Padova Italy
Oncology Operative Unit Santa Maria delle Grazie Hospital ASL NA2 NORD Pozzuoli Naples 80078 Italy
Oncology Unit A R N A S Civico Palermo Italy
Oncology Unit Macerata Hospital Macerata Italy
Oncology Unit University Hospital of Parma Via Gramsci 14 43126 Parma Italy
Citace poskytuje Crossref.org
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