Improved Survival of Real-world Japanese Patients With Advanced Renal Cell Carcinoma Treated With Immuno-oncology Combination Therapy
Improved Survival of Real-world Japanese Patients With Advanced Renal Cell Carcinoma Treated With Immuno-oncology Combination Therapy
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DOI：
10.21873/anticanres.15960
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发表时间：
2022-09-01
影响因子：
2
通讯作者：
Igawa, T. S. U. K. A. S. A.
中科院分区：
文献类型：
--
作者：
Ueda, K. O. S. U. K. E.;Suekane, S. H. I. G. E. T. A. K. A.;Igawa, T. S. U. K. A. S. A.
背景/目的：免疫肿瘤学（IO）联合治疗已成为晚期肾细胞癌（RCC）的标准治疗。在这项回顾性研究中，我们使用日本患者的真实数据比较了一线分子靶向治疗（MTT）（单药治疗）和IO联合治疗的疗效。患者和方法：收集并回顾性分析2008年5月至2022年5月期间在库尔斯克大学医院接受MTT（n=144）或IO（n=58）联合治疗的202例RCC患者的临床信息。采用考克斯比例风险模型进行单变量和多变量分析，计算风险比（HR）和95%置信区间（CI）。结果如下：与MTT治疗组相比，IO联合治疗组患者的无进展生存期（PFS）延长（p=0.0038）。IO联合治疗与中等风险（p=0.0072）和低风险（p=0.0411）患者的PFS改善显著相关，但与良好风险患者无关（p=0.5434）。此外，IO联合治疗的总生存率在低风险患者中显著更好（p=0.0335）。多变量分析表明，既往肾切除术（HR=1.501，95%CI=1.048-2.150，p=0.0268）和一线治疗（HR=1.962，95%CI=1.288-2.986，p=0.0017）是PFS的独立预后因素。结论：IO联合治疗显著改善晚期RCC患者的PFS，尤其是中危和低危患者。进一步的研究重点是提高生存率是必要的。
Background/Aim: Immuno-oncology (IO) combination therapy has become the standard of treatment for advanced renal cell carcinoma (RCC). In this retrospective study, we compared the efficacy of first-line molecular targeted therapy (MTT), administered as monotherapy, and IO combination therapy using real-world data of Japanese patients. Patients and Methods: The clinical information of 202 patients with RCC who received MTT (n=144) or IO combination therapy (n=58) at the Kurume University Hospital from May 2008 to May 2022 was collected and retrospectively analyzed. The Cox proportional hazards model was used for univariate and multivariate analyses, with hazard ratios (HRs) and 95% confidence intervals (CIs) calculated. Results: The patients treated with IO combination therapy had a prolonged progression-free survival (PFS) compared with those treated with MTT (p=0.0038). IO combination therapy was significantly associated with a better PFS in patients with intermediate (p=0.0072) and poor risk (p=0.0411) but not in those with favorable risk (p=0.5434). Furthermore, overall survival with IO combination therapy was significantly better in patients at poor risk (p=0.0335). Multivariate analyses suggested that prior nephrectomy (HR=1.501, 95%CI=1.048-2.150, p=0.0268) and first-line therapy (HR=1.962, 95%CI=1.288-2.986, p=0.0017) were independent prognostic factors for PFS. Conclusion: IO combination therapy significantly improved the PFS of patients with advanced RCC, especially those with intermediate-and poor-risk disease. Further investigations focusing on the improvement of survival are warranted.