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.
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.
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).
IO + IO and IO + TKI as first-line therapies in mRCC patients were both comparable as for the oncological outcome and toxicity.
Urologia internationalis. 2022 Feb 14 [Epub ahead of print]
Benedikt Hoeh, Philipp Schmucker, Niklas Klümper, Oliver Hahn, Philip Zeuschner, Severine Banek, Pierre I Karakiewicz, Jörg Ellinger, Julia Heinzelbecker, Michael Hölzel, Arne Strauß, Friedemann Zengerling, Angelika Mattigk, Charis Kalogirou
Department of Urology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany., Department of Urology and Paediatric Urology, Julius Maximilians University Medical Center of Würzburg, Würzburg, Germany., Department of Urology, University Hospital Bonn (UKB), Bonn, Germany., Department of Urology, University Medical Center Göttingen, Göttingen, Germany., Department of Urology and Paediatric Urology, Saarland University, Homburg, Germany., Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montreal, Québec, Canada., Institute of Experimental Oncology, University Hospital Bonn (UKB), Bonn, Germany., Department of Urology and Paediatric Urology, University Hospital Ulm, Ulm, Germany.