It remains unclear whether kidney function affects outcomes following immune checkpoint inhibitor (ICI)-based combination therapy for advanced renal cell carcinoma (RCC).
We retrospectively evaluated data of 167 patients with advanced RCC, including 98 who received ICI dual combination therapy (ie, immunotherapy [IO]-IO) and 69 who received ICI combined with tyrosine kinase inhibitor (TKI) (ie, IO-TKI). In each regimen, treatment profiles were assessed according to the grade of chronic kidney disease (CKD) as defined by the KDIGO 2012 criteria.
Of the 98 patients who received IO-IO, 31 (32%), 30 (31%), 15 (15%), and 22 (22%) had CKD G1/2, G3a, G3b, and G4/5, respectively. Of the 69 patients who received IO-TKI, 18 (26%), 25 (36%), and 26 (38%) had G1/2, G3a, and G3b/4/5, respectively. Regarding efficacy, progression-free survival, overall survival, or objective response rate was not different according to the CKD grade in both treatment groups (P > .05). Regarding safety, the rate of adverse events, treatment interruption, or corticosteroid administration was not different according to the CKD grade in the IO-IO group (P > .05), whereas in the IO-TKI group, the incidence of grade ≥ 3 adverse events were significantly higher (P = .0292), and the rates of ICI interruption (P = .0353) and corticosteroid administration (P = .0685) increased, according to the CKD grade.
There is a differential safety but comparable efficacy profile between the IO-IO and IO-TKI regimens in patients with CKD. Further prospective studies are required to confirm these findings.
Clinical genitourinary cancer. 2024 Jan 15 [Epub ahead of print]
Hiroki Ishihara, Yuki Nemoto, Hidekazu Tachibana, Takashi Ikeda, Hironori Fukuda, Kazuhiko Yoshida, Hirohito Kobayashi, Junpei Iizuka, Hiroaki Shimmura, Yasunobu Hashimoto, Tsunenori Kondo, Toshio Takagi
Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan. Electronic address: ., Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan; Department of Urology, Tokyo Women's Medical University Adachi Medical Center, Adachi-ku, Tokyo, Japan; Department of Urology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Saitama, Japan., Department of Urology, Saiseikai Kazo Hospital, Kazo, Saitama, Japan., Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan., Department of Urology, Tokyo Women's Medical University Adachi Medical Center, Adachi-ku, Tokyo, Japan., Department of Urology, Jyoban Hospital, Iwaki, Fukushima, Japan., Department of Urology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Saitama, Japan.