Comparison of nivolumab plus ipilimumab with tyrosine kinase inhibitors as first-line therapies for metastatic renal-cel
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ORIGINAL ARTICLE
Comparison of nivolumab plus ipilimumab with tyrosine kinase inhibitors as first‑line therapies for metastatic renal‑cell carcinoma: a multicenter retrospective study Koichi Kido1 · Shingo Hatakeyama1,2 · Kazuyuki Numakura3 · Toshikazu Tanaka4 · Masaaki Oikawa5 · Daisuke Noro6 · Shogo Hosogoe7 · Shintaro Narita3 · Takamitsu Inoue3 · Takahiro Yoneyama8 · Hiroyuki Ito9 · Shoji Nishimura5 · Yasuhiro Hashimoto1 · Toshiaki Kawaguchi4 · Tomonori Habuchi3 · Chikara Ohyama1,2 Received: 11 July 2020 / Accepted: 23 September 2020 © Japan Society of Clinical Oncology 2020
Abstract 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 NivoIpi group than those in the TKIs group. Conclusions The oncological outcomes of patients receiving the first-line therapy of nivolumab plus ipilimumab in realworld practice were significantly improved in comparison with first-line TKIs therapy. Keywords Renal-cell carcinoma · Nivolumab · Ipilimumab · Tyrosine kinase inhibitors · Survival
Introduction Renal-cell carcinoma (RCC) accounts for about 2–4% of all cancers and is the third-most common urological malignancy [1]. The incidence of RCC is increasing and approximately 30% of RCC patients have distant metastases at diagnosis [2–4]. The introduction of tyrosine kinase inhibitors Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10147-020-01797-5) contains supplementary material, which is available to authorized users. * Shingo Hatakeyama shingoh@hirosaki‑u.ac.jp Extended author information available on the last page of the article
(TKIs) and immunotherapies remarkably improved the survival of patients with metastatic renal-cell carcinoma (mRCC) [5–11]. In 2
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