Efficacy and Safety of Axitinib Therapy After Nivolumab for Patients With Metastatic Renal Cell Cancer
Efficacy and Safety of Axitinib Therapy After Nivolumab for Patients With Metastatic Renal Cell Cancer
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DOI：
10.21873/anticanres.14671
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发表时间：
2020-11-01
影响因子：
2
通讯作者：
Yonese, Junji
中科院分区：
文献类型：
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作者：
Yasuoka, Shotaro;Yuasa, Takeshi;Yonese, Junji
背景/目的：酪氨酸激酶抑制剂(TKI)和免疫检查点抑制剂(ICI)是转移性肾癌(MRCC)的治疗选择。然而，nivolumab之后的治疗选择尚不清楚。患者和方法：回顾了连续57例接受阿昔替尼治疗的日本肾细胞癌患者的病历。其中17例患者在nivolumab后接受axitinib治疗，40例患者在除nivolumab外的其他化疗方案后接受axitinib治疗。结果：57例肾细胞癌患者中，仅17例在尼伏鲁单抗治疗后接受阿昔替尼治疗。17例患者的客观有效率(ORR)为56.3%，中位肿瘤缩小率为-30%。在尼伏单抗后接受阿昔替尼治疗的患者的疗效明显好于其他治疗后的患者(分别为p=0.026和p=0.012)。然而，所有17名患者都经历了一些不良事件，9名患者(52.9%)需要减少剂量或中断阿西替尼治疗。结论：阿西替尼在免疫检查点抑制剂nivolumab治疗后疗效良好，不良反应风险适中。可能需要熟练的专业人员进行仔细的管理。
Background/Aim: Tyrosine kinase inhibitors (TKI) and immune-checkpoint inhibitors (ICI) are treatment options for metastatic renal cell cancer (mRCC). However, the treatment options after nivolumab are unclear. Patients and Methods: The medical records of 57 consecutive Japanese mRCC patients who underwent treatment with axitinib were reviewed. Among those, 17 patients received axitinib treatment after nivolumab and 40 patients received axitinib treatment after other chemotherapy regimens except nivolumab. Results: Of the 57 patients with mRCC, only 17 underwent axitinib therapy after nivolumab. Among these 17 patients, the objective response rate (ORR) and median tumor shrinkage rate were 56.3% and -30%, respectively. They were significantly better in patients who underwent axitinib therapy after nivolumab than after other therapies (p=0.026 and p=0.012, respectively). However, all 17 patients experienced some adverse events and nine patients (52.9%) required a dose reduction or axitinib treatment interruption. Conclusion: Axitinib therapy after the immune checkpoint inhibitor nivolumab showed good efficacy with a moderate risk of adverse events. Careful management by skilled professionals may be required.