Comparison of nivolumab plus ipilimumab with tyrosine kinase inhibitors as first-line therapies for metastatic renal-cell carcinoma: a multicenter retrospective study
Comparison of nivolumab plus ipilimumab with tyrosine kinase inhibitors as first-line therapies for metastatic renal-cell carcinoma: a multicenter retrospective study
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DOI：
10.1007/s10147-020-01797-5
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发表时间：
2020-10-16
影响因子：
3.3
通讯作者：
Ohyama, Chikara
中科院分区：
文献类型：
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作者：
Kido, Koichi;Hatakeyama, Shingo;Ohyama, Chikara
背景 本研究比较了接受酪氨酸激酶抑制剂或纳武单抗加伊匹单抗治疗的转移性肾细胞癌 (mRCC) 患者的真实结果。方法 利用国际 mRCC 数据库联盟（IMDC），我们回顾性评估了 2015 年 8 月至 2020 年 1 月期间接受纳武单抗联合易普利姆玛（Nivo-Ipi）、酪氨酸激酶抑制剂（TKI）作为一线治疗的中危和低危 mRCC 患者。我们使用治疗逆概率的多变量逻辑回归分析比较了 Nivo-Ipi 组和 TKI 组之间的肿瘤学结果加权（IPTW）方法。结果 本研究共纳入 278 名患者。 Nivo-Ipi 组和 TKI 组（舒尼替尼 97 例、阿西替尼 118 例、索拉非尼 9 例、帕唑帕尼 2 例）分别有 52 例和 226 例患者。 Nivo-Ipi 组和 TKI 组的中位年龄分别为 69 岁和 67 岁。各组之间的年龄、体力状态、肾切除史和 IMDC 风险组分布没有显着差异。 Nivo-Ipi 组的客观缓解率（38%）显着高于 TKI 组（23%，P = 0.018）。 IPTW 调整的 Cox 回归分析显示，Nivo-Ipi 组的无进展生存率（风险比 0.60，P = 0.039）和总生存率（风险比 0.51，P = 0.037）显着高于 TKI 组。结论 与一线 TKI 治疗相比，在现实实践中接受纳武单抗联合伊匹单抗一线治疗的患者的肿瘤学结果显着改善。
Background This study compared real-world outcomes of metastatic renal-cell carcinoma (mRCC) patients treated with tyrosine kinase inhibitors or nivolumab plus ipilimumab. Methods Using the International mRCC Database Consortium (IMDC), we retrospectively evaluated intermediate- and poor-risk mRCC patients who were treated with nivolumab plus ipilimumab (Nivo-Ipi), tyrosine kinase inhibitors (TKIs) as the first-line therapy between August 2015 and January 2020. We compared oncological outcomes between the Nivo-Ipi group and TKIs group using multivariate logistic regression analysis with the inverse probability of treatment weighting (IPTW) method. Results In this study 278 patients were included. There were 52 and 226 patients in the Nivo-Ipi and TKIs groups (sunitinib 97, axitinib 118, sorafenib 9, pazopanib 2), respectively. The median age in the Nivo-Ipi and TKIs groups were 69 and 67 years, respectively. There was no significant difference in age, performance status, history of nephrectomy, and the IMDC risk group distribution between the groups. The objective response rate was significantly higher in the Nivo-Ipi group (38%) than in the TKIs group (23%,P = 0.018). The IPTW-adjusted Cox regression analysis showed that a significantly longer progression-free survival (hazard ratio 0.60,P = 0.039) and overall survival (hazard ratio 0.51,P = 0.037) rates in the Nivo-Ipi group than those in the TKIs group. Conclusions The oncological outcomes of patients receiving the first-line therapy of nivolumab plus ipilimumab in real-world practice were significantly improved in comparison with first-line TKIs therapy.