Salvage Ipilimumab and Nivolumab in Patients With Metastatic Renal Cell Carcinoma After Prior Immune Checkpoint Inhibitors
Salvage Ipilimumab and Nivolumab in Patients With Metastatic Renal Cell Carcinoma After Prior Immune Checkpoint Inhibitors
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DOI：
10.1200/jco.19.03315
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发表时间：
2020-09-20
影响因子：
45.3
通讯作者：
Rini, Brian I.
中科院分区：
文献类型：
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作者：
Gul, Anita;Stewart, Tyler F.;Rini, Brian I.
免疫检查点抑制剂（ICIs）是转移性肾细胞癌（RCC）的标准治疗方法。ipilimumab和nivolumab联合用于先前接受过针对程序性死亡1 （PD-1）途径的ICI的患者的安全性和活性尚不清楚。我们评估了ipilimumab和nivolumab在既往接受抗pd -1通路靶向治疗的转移性RCC患者中的应用。患者和方法回顾了先前接受抗pd -1途径靶向治疗并随后接受伊匹单抗和纳沃单抗治疗的转移性RCC患者。记录每位研究者评估的客观缓解率和无进展生存期。伊匹单抗和纳武单抗的毒性也进行了评估。结果纳入45例转移性肾细胞癌患者。所有患者（100%）先前都接受了靶向PD-1通路的ICIs。中位年龄为62岁（范围21-82岁）。在中位随访12个月时，伊匹单抗和纳武单抗的客观缓解率为20%。伊匹单抗和纳武单抗的中位无进展生存期为4个月（范围0.8-19个月）。45例患者中有29例（64%）记录了伊匹单抗和纳武单抗任何级别的免疫相关不良事件（irae）；45例患者中有6例（13%）发生3级irae。结论：Ipilimumab和nivolumab在既往接受检查点抑制治疗的转移性RCC患者中显示出抗肿瘤活性和可接受的毒性。(C)美国临床肿瘤学会2020
PURPOSE Immune checkpoint inhibitors (ICIs) are standard therapy in metastatic renal cell carcinoma (RCC). The safety and activity of the combination of ipilimumab and nivolumab in patients who have received prior ICI targeting the programmed death 1 (PD-1) pathway remains unknown. We evaluated ipilimumab and nivolumab in patients with metastatic RCC after prior treatment with anti-PD-1 pathway-targeted therapy.PATIENTS AND METHODS Patients with metastatic RCC who received prior anti-PD-1 pathway-targeted therapy and subsequently received ipilimumab and nivolumab were reviewed. Objective response rate and progression-free survival per investigator assessment were recorded. Toxicity of ipilimumab and nivolumab was also assessed.RESULTS Forty-five patients with metastatic RCC were included. All patients (100%) received prior ICIs targeting the PD-1 pathway. The median age was 62 years (range, 21-82 years). At a median follow-up of 12 months, the objective response rate to ipilimumab and nivolumab was 20%. The median progression-free survival while on ipilimumab and nivolumab was 4 months (range, 0.8-19 months). Immune-related adverse events (irAEs) of any grade with ipilimumab and nivolumab were recorded in 29 (64%) of the 45 patients; grade 3 irAEs were recorded in 6 (13%) of the 45 patients.CONCLUSION Ipilimumab and nivolumab demonstrated antitumor activity with acceptable toxicity in patients with metastatic RCC who had prior treatment with checkpoint inhibition. (C) 2020 by American Society of Clinical Oncology