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First-line immune-based combinations or sunitinib in favorable-risk metastatic renal cell carcinoma: a real-world retrospective comparison from the ARON-1 study
G. Roviello, J. Molina-Cerrillo, F. Massari, L. Cerbone, O. Fiala, G. Fornarini, FSM. Monteiro, C. Cattrini, J. Landmesser, C. Messina, A. Zgura, SE. Rebuzzi, A. Soares, F. Carrozza, J. Ansari, F. Grillone, Z. Küronya, L. Incorvaia, D. Bhuva, C....
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články, multicentrická studie, srovnávací studie
NLK
Directory of Open Access Journals
od 2024
PubMed Central
od 1982
Springer Journals Complete - Open Access
od 2024-01-01
Springer Nature OA/Free Journals
od 2024-01-01
- MeSH
- chinoliny terapeutické užití aplikace a dávkování MeSH
- dospělí MeSH
- fenylmočovinové sloučeniny terapeutické užití aplikace a dávkování MeSH
- inhibitory kontrolních bodů * terapeutické užití MeSH
- inhibitory proteinkinas terapeutické užití MeSH
- karcinom z renálních buněk * farmakoterapie imunologie mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- metastázy nádorů MeSH
- nádory ledvin * farmakoterapie imunologie mortalita patologie MeSH
- prognóza MeSH
- protokoly protinádorové kombinované chemoterapie * terapeutické užití MeSH
- pyridiny MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- sunitinib * terapeutické užití MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- srovnávací studie MeSH
INTRODUCTION: Renal cell carcinoma (RCC) is one of the most common types of urogenital cancer. The introduction of immune-based combinations, including dual immune-checkpoint inhibitors (ICI) or ICI plus tyrosine kinase inhibitors (TKIs), has radically changed the treatment landscape for metastatic RCC, showing varying efficacy across different prognostic groups based on the International Metastatic RCC Database Consortium (IMDC) criteria. MATERIALS AND METHODS: This retrospective multicenter study, part of the ARON-1 project, aimed to evaluate the outcomes of favorable-risk metastatic RCC patients treated with immune-based combinations or sunitinib. Patients were assessed for overall survival (OS), progression-free survival (PFS) and overall response rate. We carried out a survival analysis by a Cox regression model. RESULTS: A total of 524 favorable-risk patients were included in the analysis. After a median follow-up of 37.2 months, the median OS in the overall population was 56.1 months. There was no significant difference in OS between patients receiving sunitinib and those receiving TKI + ICI combinations (p = 0.761). Patients on TKI + ICI had significantly longer PFS compared to patient treated with sunitinib (30.7 vs 22.9 months, p = 0.007). Analysis of OS and PFS based on metastatic site revealed that patients with bone metastases benefited more from ICI plus TKI (56 patients with bone metastases receiving IO + TKI, 38 received pembrolizumab plus axitinib, 15 cabozantinib plus nivolumab and 3 pembrolizumab plus lenvatinib), while sunitinib was more effective for pancreatic and glandular metastases. Additionally, the number of metastatic sites played a role, with TKI plus ICI showing superiority in patients with a single metastatic site. The time from RCC diagnosis to metastatic disease also impacted outcomes, with TKI plus ICI being more effective in patients with a shorter interval (i.e., < 36 months). CONCLUSIONS: The choice between upfront combination or monotherapy for metastatic favorable prognosis RCC remains a current issue. While combination therapy offers prolonged PFS, it does not necessarily translate to improve OS compared to sunitinib. This real-world study supports the superiority in terms of PFS of TKI plus ICI vs TKI monotherapy but not in OS. Probable, other clinical factors should be taking into account to make clinical treatment decisions in this setting.
Alcalá University Madrid Spain
Department of Internal Medicine and Medical Specialties University of Genoa Genoa Italy
Department of Medical and Surgical Sciences University of Bologna Bologna Italy
Department of Medical Oncology Army Hospital Research and Referral New Delhi India
Department of Medical Oncology AUSL Della Romagna Ospedale Civile Degli Infermi Faenza Italy
Department of Medical Oncology Hospital Ramón y Cajal Madrid Spain
Department of Medical Oncology Maggiore Della Carità University Hospital 28100 Novara Italy
Department of Medical Oncology San Camillo Forlanini Hospital Rome Italy
Division of Medical Oncology National Cancer Centre Singapore Singapore Singapore
Faculty of Medicine in Pilsen Biomedical Center Charles University Pilsen Czech Republic
Hospital Israelita Albert Einstein São Paulo SP Brazil
IRCCS Ospedale Policlinico San Martino Genoa Italy
Klinik Für Urologie Ratzeburger Allee 160 23538 Lübeck Germany
Latin American Cooperative Oncology Group LACOG Porto Alegre Brazil
Medical Oncology IRCCS Azienda Ospedaliero Universitaria Di Bologna Via Albertoni 15 Bologna Italy
Medical Oncology Ospedale Santa Corona 17027 Pietra Ligure Italy
Medical Oncology Tawam Hospital Al Ain United Arab Emirates
Oncology and Hematology Department Hospital Sirio Libanês SGAS 613 Lote 94 Brasília DF Brazil
Oncology Unit A R N A S Civico Palermo Italy
Oncology Unit Macerata Hospital Macerata Italy
Ospedale San Paolo Medical Oncology 17100 Savona Italy
SOC Oncologia PO Pugliese Ciaccio Azienda Ospedaliera Universitaria Renato Dulbecco Catanzaro Italy
Citace poskytuje Crossref.org
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