The first-line therapy of metastatic renal cell carcinoma (mRCC) has revolutionized with the approval of immune checkpoint inhibitors (ICIs) in combination with or without tyrosine kinase inhibitors (TKIs). The choice among the many different immuno-combinations (ICI-ICI or ICI-TKI) is challenging due to the lack of predictive factors. The different shapes of the Kaplan-Meier survival curves (e.g. "banana-shaped curves") have raised many questions on the long-term survival benefit. Here, we analyzed the factors that could have impacted the different long-term survival, including the prognostic factors distribution (IMDC score), histological factors (sarcomatoid features, PD-L1 expression), and treatment characteristics (mechanism of action, duration, discontinuation rate). This overview highlights the factors that should be considered in the first-line setting for the patients' therapeutic choice and prognostic assessment. They are also fundamental parameters to examined for head-to-head studies and real-life, large-scale studies.
Human vaccines & immunotherapeutics. 2024 May 17 [Epub]
Sara Elena Rebuzzi, Giuseppe Fornarini, Alessio Signori, Pasquale Rescigno, Giuseppe Luigi Banna, Sebastiano Buti
Medical Oncology Unit, Ospedale San Paolo, Savona, Italy., Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy., Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genova, Genova, Italy., Translationsal and Clinical Research Institute, Centre for Cancer, Newcastle University, Newcastle Upon Tyne, UK., Department of Oncology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK., Medical Oncology Unit, University Hospital of Parma, Parma, Italy.