AI Article Synopsis
- The study aimed to compare overall survival (OS) and progression-free survival (PFS) rates, as well as toxicity, between two immune checkpoint inhibition (IO) combination therapies in patients with metastatic renal-cell carcinoma (mRCC).
- Data was analyzed from 104 mRCC patients treated with either an IO + IO combination (nivolumab + ipilimumab) or an IO + TKI combination (pembrolizumab + axitinib) over a period from November 2017 to April 2021.
- Results indicated that while both therapies had similar survival outcomes and toxicity levels, older patients (≥70 years) showed a significantly better OS rate with the IO + TKI therapy compared to the
Article Abstract
Introduction: The aim of this study was to test for differences in overall (OS) and progression-free survival (PFS) rates and toxicity in first-line immune checkpoint inhibition (IO) combination therapy in metastatic renal-cell carcinoma (mRCC) patients.
Methods: Between November 2017 and April 2021, 104 patients with histologically confirmed mRCC from 6 tertiary referral centers with either IO + IO (nivolumab + ipilimumab, n = 68) or IO + tyrosine kinase inhibitor (TKI) (pembrolizumab + axitinib, n = 36) were included. Kaplan-Meier and Cox regression analyses tested for OS and PFS differences.
Results: Of 104 mRCC patients, 68 received IO + IO (65.4%) and 36 IO + TKI (34.6%) therapy, respectively. Median age was 67 years (interquartile range: 57-70.3). Patients receiving IO + TKI were less likely to be poor risk according to the International Metastatic Renal-Cell Carcinoma Database Consortium score (16.7 vs. 30.9%) and presented with lower T-stage, compared to IO + IO treated patients. Median PFS was 9.8 months (CI: 5.3-17.6) versus 12.3 months (CI: 7.7 - not reached) for IO + IO versus IO + TKI treatment, respectively (p = 0.22). Median OS was not reached, survival rates at 12 months being 73.9 versus 90.0% for IO + IO versus IO + TKI patients (p = 0.089). In subgroup analyses of elderly patients (≥70 years, n = 38), IO + TKI treatment resulted in better OS rates at 12 months compared to IO + IO (91.0 vs. 57.0%; p = 0.042).
Conclusion: IO + IO and IO + TKI as first-line therapies in mRCC patients were both comparable as for the oncological outcome and toxicity.
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