Publications by authors named "Escudier B"

Background: The Fast Real-time Assessment of Combination Therapies in Immuno-ONcology study in patients with aRCC (FRACTION-RCC) was designed to assess new immuno-oncology (IO) combinations in patients with advanced renal cell carcinoma (aRCC). We present results in IO-naive patients treated with nivolumab (NIVO) + relatlimab (RELA) or NIVO + ipilimumab (IPI) in track 1.

Methods: The open-label, randomised, phase II FRACTION-RCC trial enrolled patients with aRCC from 32 hospitals and cancer centres across six countries.

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  • Immunotherapy, like the combination of nivolumab and ipilimumab (NIVO+IPI), can lead to prolonged disease control and treatment-free survival (TFS) for cancer patients, even after stopping treatment, which is not accounted for by standard survival measures.
  • A study analyzed data from 1,096 advanced renal cell carcinoma patients to estimate TFS, comparing those treated with NIVO+IPI against sunitinib (SUN), focusing on both survival time and treatment-related adverse events (TRAEs).
  • Results showed that 48% of patients on NIVO+IPI were alive after 5 years, with a significant difference in mean TFS compared to SUN, particularly in favorable-risk patients, highlighting the importance of considering
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  • The gut microbiota plays a significant role in how cancer patients respond to immune checkpoint inhibitors (ICIs), but there’s no clear definition of harmful dysbiosis.* -
  • Researchers analyzed fecal samples from 245 non-small cell lung cancer (NSCLC) patients, identifying specific bacterial species groups associated with either resistance or response to ICIs, resulting in the creation of a topological score (TOPOSCORE).* -
  • This TOPOSCORE was further validated in additional patient cohorts and transformed into a 21-bacterial probe set for qPCR scoring, suggesting it could serve as a dynamic tool for diagnosing intestinal dysbiosis and tailoring microbiota-focused treatments.*
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Background: Nivolumab is the first immune checkpoint inhibitor approved in Europe for the treatment of advanced renal cell carcinoma (aRCC) in patients resistant to prior antiangiogenic therapy. WITNESS is an ongoing, prospective, observational study designed to evaluate the effectiveness and safety of nivolumab in patients with aRCC treated in real life (or routine practice) in France (ClinicalTrials.gov identifier: NCT03455452).

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In oncology, the place of patients has a natural and strong legitimacy. Cancer is a common disease, with many singularities but also common features between pathologies, with issues ranging from prevention to possible palliative phases or post-cancer, and conducive to both individual and collective decision-making processes. Patient engagement is now essential at all levels of the healthcare system, from simple information to real involvement (co-construction).

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  • The study examines the Lung Immune Prognostic Index (LIPI) to see if it can predict survival in patients with metastatic renal cell carcinoma (mRCC).
  • LIPI categorizes patients into groups based on specific blood markers, and results show that those with a better LIPI score have significantly longer overall and progression-free survival.
  • The findings indicate that LIPI can be a useful prognostic tool for mRCC patients regardless of the type of treatment they receive, whether it’s immune checkpoint inhibitors or antiangiogenic therapy.
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Background: Nivolumab plus cabozantinib (NIVO + CABO) was approved for first-line treatment of advanced renal cell carcinoma (aRCC) based on superiority versus sunitinib (SUN) in the phase III CheckMate 9ER trial (18.1 months median survival follow-up per database lock date); efficacy benefit was maintained with an extended 32.9 months of median survival follow-up.

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Immunotherapy profoundly changed the landscape of cancer therapy by providing long-lasting responses in subsets of patients and is now the standard of care in several solid tumor types. However, immunotherapy activity beyond conventional immune checkpoint inhibition is plateauing, and biomarkers are overall lacking to guide treatment selection. Most studies have focused on T cell engagement and response, but there is a growing evidence that B cells may be key players in the establishment of an organized immune response, notably through tertiary lymphoid structures.

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Introduction: Immune checkpoint inhibitors are standard of care in metastatic renal cell carcinoma but their activity and safety in elderly patients is insufficiently explored. We evaluated outcomes of elderly patients with mRCC treated with nivolumab in the GETUG-AFU 26 NIVOREN phase 2 trial (NCT03013335) and conducted exploratory circulating biomarker analyses.

Methods: Patients with mRCC were treated with nivolumab after at least one antiangiogenic therapy.

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Background: Tivozanib is an oral vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor (TKI) with efficacy in advanced renal cell carcinoma (RCC). Long-term exploratory analyses from the TIVO-3 trial in relapsed/refractory (R/R) RCC including patients (26%) with prior immuno-oncology (IO) therapy are reported.

Methods: Patients with R/R advanced RCC that progressed with 2 or 3 prior systemic therapies (≥1 VEGFR TKI) were randomized to tivozanib 1.

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Background: Papillary renal cell carcinoma (pRCC) is the most common non-clear cell RCC, and associated with poor outcomes in the metastatic setting. In this study, we aimed to comprehensively evaluate the immune tumor microenvironment (TME), largely unknown, of patients with metastatic pRCC and identify potential therapeutic targets.

Methods: We performed quantitative gene expression analysis of TME using Microenvironment Cell Populations-counter (MCP-counter) methodology, on two independent cohorts of localized pRCC (n=271 and n=98).

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Article Synopsis
  • Glandular metastases (GMs) are uncommon in metastatic clear cell renal cell carcinoma (mccRCC), but patients with GMs treated with antiangiogenic therapy show better survival outcomes.
  • The GETUG-AFU-26 NIVOREN trial analyzed the effects of nivolumab on mccRCC patients, categorizing them based on the presence of GMs to compare survival outcomes.
  • Among 720 patients, those with adrenal GMs had poorer overall survival and response rates, while those with pancreatic GMs had significantly better survival rates compared to nonpancreatic metastasis.
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Background: Despite metastatic renal cell carcinoma (mRCC) expanded treatment options, disease progression ultimately occurs for most patients. Rechallenge may be a compelling strategy in a refractory setting. Cabozantinib is the standard of care in first and later lines of therapy, but its activity in rechallenge is unknown.

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Introduction: Bone metastases (BM) in renal cell carcinoma (RCC) are associated with a poor prognosis based on retrospective studies evaluating antiangiogenic agents. Few data are available regarding immune checkpoint inhibitors (ICI) in patients with bone metastatic RCC. NIVOREN is a multicentre prospective study in which patients were treated with nivolumab after the failure of antiangiogenic agents.

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Background: In phase III TIVO-3 trial, tivozanib improved progression-free survival (PFS) compared to sorafenib for patients with metastatic renal cell carcinoma (mRCC). However, the effectiveness of this drug after exposure to other selective VEGFR agents has not yet been defined. Herein, we characterize the clinical efficacy of tivozanib in patients with mRCC previously treated with axitinib.

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Background: Immune checkpoint inhibitor-based combination therapy (ICI-based combination) is a new standard of care for metastatic clear cell renal cell carcinoma (mRCC) in the frontline setting. Patients with poor performance status (PS) (≥2) were excluded from pivotal trials. Hence, the activity and safety of ICI-based combination therapy in this group of patients is still unknown.

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Background: The role and sequencing of combination immuno-oncology (IO) therapy following progression on or after first-line IO therapy has not been well-established. The Fast Real-time Assessment of Combination Therapies in Immuno-ONcology (FRACTION) program is an open-label, phase 2 platform trial designed to evaluate multiple IO combinations in patients with advanced renal cell carcinoma (aRCC) who progressed during or after prior IO therapy. Here, we describe the results for patients treated with nivolumab plus ipilimumab.

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Background: The phase III CheckMate 9ER trial originally included a nivolumab plus ipilimumab plus cabozantinib triplet arm, which was discontinued early due to the evolving treatment landscape for first-line advanced renal cell carcinoma (aRCC). We report an exploratory analysis of patients randomised to the triplet regimen before enrolment discontinuation.

Methods: Patients with clear-cell aRCC received nivolumab (3 mg/kg) plus ipilimumab (1 mg/kg) Q3W for four cycles with once-daily cabozantinib (40 mg), then nivolumab (240 mg) Q2W plus once-daily cabozantinib (40 mg).

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Introduction: Tivozanib, vascular endothelial growth factor receptor inhibitor, met the primary endpoint of improved progression free survival compared to sorafenib in the phase 3 TIVO-3 study in patients with previously treated metastatic renal cell carcinoma. In this study we sought to understand the temporal characteristics of treatment related adverse events (TRAEs) and frequency and timing of the dose modifications.

Materials And Methods: In this open label, randomized, phase 3 TIVO-3 study, previously treated patients with a diagnosis of metastatic renal cell carcinoma and with measurable disease were included.

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Background: The introduction of novel systemic therapies for metastatic renal cell carcinoma (mRCC) over the last decade has significantly improved patient outcomes. Little information is available on treatment modalities and outcomes in everyday practice. The objective of this study was to describe patient characteristics, treatment patterns, and healthcare resource use in mRCC patients receiving systemic therapy in France (2014-2017), using the nationwide claims database.

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Importance: Dysregulated metabolism is a hallmark of renal cell carcinoma (RCC). Glutaminase is a key enzyme that fuels tumor growth by converting glutamine to glutamate. Telaglenastat is an investigational, first-in-class, selective, oral glutaminase inhibitor that blocks glutamine utilization and downstream pathways.

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Article Synopsis
  • Proton pump inhibitors (PPIs) might affect the gut microbiome and could influence the effectiveness of immune checkpoint inhibitors (ICIs) in metastatic renal cell carcinoma (mRCC), but this has not been fully studied.
  • A retrospective analysis of 707 patients from a phase II study found that 27.7% were PPI users, mostly males with good performance status, but their PPI use did not show a significant impact on progression-free survival (PFS) or overall survival (OS).
  • However, PPI users experienced a higher rate of severe nivolumab-related side effects, indicating that while PPI may not affect treatment efficacy, it could impact safety, suggesting the need for further research.
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  • Cabozantinib, a treatment for metastatic renal cell carcinoma (mRCC), may lead to significant weight and muscle loss, which is under-researched in this context.
  • A study analyzed 101 mRCC patients treated with cabozantinib, revealing that 85 experienced muscle loss, especially after 6 months, and many started with or developed sarcopenia (muscle wasting) during treatment.
  • The presence of baseline sarcopenia was linked to lower treatment response rates and higher occurrences of severe side effects, with nearly half of the patients analyzed also experiencing significant weight loss.
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Immune checkpoint inhibitor combinations have reshaped the treatment landscape of metastatic clear-cell renal cell carcinoma. As four regimens are now approved in the first-line setting, including nivolumab plus ipilimumab in intermediate and poor-risk patients, and pembrolizumab plus lenvatinib, nivolumab plus cabozantinib and pembrolizumab plus axitinib in all-comers, the choice of subsequent therapies is becoming a novel challenge for physicians. Such choices now rely on several compounds used as monotherapy which have demonstrated sustained activity after previous immune checkpoint or tyrosine kinase inhibitors.

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