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Real-World Primary Resistance to First-Line Immune-Based Combinations in Patients with Advanced Renal Cell Carcinoma (ARON-1)
D. Santini, H. Li, G. Roviello, SH. Park, E. Grande, J. Kucharz, U. Basso, O. Fiala, FSM. Monteiro, A. Poprach, S. Buti, J. Molina-Cerrillo, M. Catalano, T. Buchler, E. Seront, J. Ansari, ZW. Myint, M. Ghosn, F. Calabrò, RM. Kopp, D. Bhuva, MT....
Jazyk angličtina Země Francie
Typ dokumentu časopisecké články, multicentrická studie
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
- chemorezistence MeSH
- dospělí MeSH
- karcinom z renálních buněk * farmakoterapie patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory ledvin * farmakoterapie patologie 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
- multicentrická studie MeSH
BACKGROUND: Therapeutic advancements based on immuno-oncology combinations have revolutionized the management of patients with renal cell carcinoma. However, patients who have progressive disease as the best response, "primary refractory" (Pref), face dismal outcomes. OBJECTIVE: Our multicenter retrospective real-world study aims to assess the prevalence and clinicopathological characteristics of Pref patients. METHODS: This study collected data from 72 centers across 22 countries (1709 patients), involving patients aged ≥18 years with metastatic clear cell renal cell carcinoma. All patients were treated with first-line immune-oncology combinations. Data included patient demographics, histology, metastatic sites, and treatment responses. Radiological assessments followed Response Evaluation Criteria in Solid Tumors version 1.1. Statistical analyses employed Kaplan-Meier method, Cox proportional hazard models, logistic regression, and the receiver operating characteristic curve. RESULTS: In our study, the Pref rate was 19%. Nivolumab/ipilimumab showed the highest Pref rate (27%), while pembrolizumab/lenvatinib exhibited the lowest (10%). Primary refactory patients demonstrated significantly lower median overall survival (7.6 months) compared with non-Pref patients (55.7 months), p < 0.001. At the multivariate analysis, nephrectomy, sarcomatoid de-differentiation, intermediate/poor International Metastatic RCC Database Consortium risk, and bone and brain metastases emerged as significant predictors of overall survival for Pref patients with renal cell carcinoma. Logistic regression showed a significant relationship between liver metastases, intermediate/poor International Metastatic RCC Database Consortium risk, and no surgery and an increased risk of Pref. This study presents limitations, mainly because of its retrospective design. CONCLUSIONS: The ARON-1 study provides valuable insights into Pref patients, emphasizing the challenges of this precociously resistant subgroup. Identified predictors could guide risk stratification, aiding clinicians in tailored therapeutic approaches.
Biomedical Center Faculty of Medicine in Pilsen Charles University Pilsen Czech Republic
Clinical Oncology Sociedad de Oncología y Hematología del Cesar Valledupar Colombia
Department of Experimental Medicine Sapienza University of Rome Rome Italy
Department of Medical and Surgical Science University of Bologna Bologna Italy
Department of Medical Oncology Army Hospital Research and Referral New Delhi India
Department of Medical Oncology Cliniques Universitaires Saint Luc Brussels Belgium
Department of Medical Oncology Hospital Ramón y Cajal Madrid Spain
Department of Medical Oncology MD Anderson Cancer Center Madrid Madrid Spain
Faculty of Medicine Masaryk University Brno Czech Republic
General Director AST3 Macerata Italy
Hematology Oncology Department Faculty of Medicine Saint Joseph University of Beirut Beirut Lebanon
Hospital Israelita Albert Einstein São Paulo SP Brazil
Hospital Sírio Libanês Brasília DF Brazil
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico City Mexico
Latin American Cooperative Oncology Group LACOG Porto Alegre Brazil
Markey Cancer Center University of Kentucky Lexington KY USA
Masaryk Memorial Cancer Institute Brno Czech Republic
Medical Oncology 1 Unit Department of Oncology Istituto Oncologico Veneto IOV IRCCS Padova Italy
Medical Oncology IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna Italy
Medical Oncology IRCCS National Cancer Institute Regina Elena Rome Italy
Medical Oncology Tawam Hospital Al Ain United Arab Emirates
Citace poskytuje Crossref.org
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- $a BACKGROUND: Therapeutic advancements based on immuno-oncology combinations have revolutionized the management of patients with renal cell carcinoma. However, patients who have progressive disease as the best response, "primary refractory" (Pref), face dismal outcomes. OBJECTIVE: Our multicenter retrospective real-world study aims to assess the prevalence and clinicopathological characteristics of Pref patients. METHODS: This study collected data from 72 centers across 22 countries (1709 patients), involving patients aged ≥18 years with metastatic clear cell renal cell carcinoma. All patients were treated with first-line immune-oncology combinations. Data included patient demographics, histology, metastatic sites, and treatment responses. Radiological assessments followed Response Evaluation Criteria in Solid Tumors version 1.1. Statistical analyses employed Kaplan-Meier method, Cox proportional hazard models, logistic regression, and the receiver operating characteristic curve. RESULTS: In our study, the Pref rate was 19%. Nivolumab/ipilimumab showed the highest Pref rate (27%), while pembrolizumab/lenvatinib exhibited the lowest (10%). Primary refactory patients demonstrated significantly lower median overall survival (7.6 months) compared with non-Pref patients (55.7 months), p < 0.001. At the multivariate analysis, nephrectomy, sarcomatoid de-differentiation, intermediate/poor International Metastatic RCC Database Consortium risk, and bone and brain metastases emerged as significant predictors of overall survival for Pref patients with renal cell carcinoma. Logistic regression showed a significant relationship between liver metastases, intermediate/poor International Metastatic RCC Database Consortium risk, and no surgery and an increased risk of Pref. This study presents limitations, mainly because of its retrospective design. CONCLUSIONS: The ARON-1 study provides valuable insights into Pref patients, emphasizing the challenges of this precociously resistant subgroup. Identified predictors could guide risk stratification, aiding clinicians in tailored therapeutic approaches.
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