Primary Tumor Shrinkage and the Effect on Metastatic Disease and Outcomes in Patients With Advanced Kidney Cancer With Intermediate or Poor Prognosis Treated With Nivolumab Plus Ipilimumab or Cabozantinib.

Autor: Iacovelli R; Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy. Electronic address: Roberto.iacovelli@policlinicogemelli.it., Ciccarese C; Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Oncologia Medica, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Roma, Italy., Maruzzo M; Oncologia 1, Dipartimento di Oncologia, Istituto Oncologico Veneto (IOV) - IRCCS, Padua, Italy., Atzori F; Unità di Oncologia Medica, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy., Galli L; UO Oncologia Medica 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy., Scagliarini S; UOC di Oncologia, Azienda Ospedaliera di Rilievo Nazionale Cardarelli di Napoli, Naples, Italy., Massari F; Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia., Verzoni E; Dipartimento di Oncologia Medica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Cannella A; Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy., Maratta MG; Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy., Caserta C; Struttura Complessa di Oncologia Medica e Traslazionale, Azienda Ospedaliera Santa Maria di Terni, Italy., Bimbatti D; Oncologia 1, Dipartimento di Oncologia, Istituto Oncologico Veneto (IOV) - IRCCS, Padua, Italy., Deppieri FM; Oncologia 1, Dipartimento di Oncologia, Istituto Oncologico Veneto (IOV) - IRCCS, Padua, Italy., Dessi M; Unità di Oncologia Medica, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy., Paolieri F; UO Oncologia Medica 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy., Riccardi F; UOC di Oncologia, Azienda Ospedaliera di Rilievo Nazionale Cardarelli di Napoli, Naples, Italy., Bracarda S; Struttura Complessa di Oncologia Medica e Traslazionale, Azienda Ospedaliera Santa Maria di Terni, Italy., De Giorgi U; Dipartimento di Oncologia Medica, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy., Basso U; Oncologia 1, Dipartimento di Oncologia, Istituto Oncologico Veneto (IOV) - IRCCS, Padua, Italy., Tortora G; Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Oncologia Medica, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Roma, Italy., Procopio G; Dipartimento di Oncologia Medica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Jazyk: angličtina
Zdroj: Clinical genitourinary cancer [Clin Genitourin Cancer] 2022 Oct; Vol. 20 (5), pp. 498.e1-498.e9. Date of Electronic Publication: 2022 Jun 09.
DOI: 10.1016/j.clgc.2022.06.006
Abstrakt: Background: Immune checkpoint inhibitor (ICI)-based combinations have become the first-line standard of care in metastatic renal cell carcinoma (mRCC), but their activity on the primary tumor is still one of the most debated issues.
Patients and Methods: The aim of our analysis was to evaluate the primary tumor's response to first-line therapy with cabozantinib or nivolumab+ipilimumab, and its correlation with metastatic response and with patient outcomes.
Results: Sixty-seven mRCC patients met the criteria for inclusion in the final analysis (30 treated with cabozantinib and 37 with nivolumab+ipilimumab). In the overall population, the primary tumor control rate (PTCR) was 90.9%; no complete responses (CR) were achieved. A significant correlation was found between the baseline size of the primary tumor's longest diameter and its response according to RECIST v1.1 criteria at the time of the second radiological assessment (rs = -0.351; P = .049). Moreover, a significant correlation between the type of primary tumor response and the response of the metastases was observed in the overall population (rs = 0.50; two-sided P < 0.001). There was also a significant correlation between primary tumor response and 1-year survival rate (P = .002), even when adjusted for the IMDC prognostic group and type of therapy (HR = 8.70; 95%CI, 2.52-30.05; P = .001).
Conclusion: Extension of the primary tumor did not affect patient survival, while its response was significantly related to the response on metastatic disease and survival. No significant differences in terms of primary tumor shrinkage were identified between treatment with nivolumab+ipilimumab or cabozantinib in this cohort.
Competing Interests: Disclosure The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. RI served as consultant for Astellas, BMS, Ipsen; Janssen, Merk, MSD, Novartis; Pfizer; Sanofi and received research grant from Pfizer. SS served as consultant for Astellas, BMS, Ipsen, Janssen, MSD, Novartis, Pfizer, Sanofi-Genzyme. EV served as consultant for Ipsen, Janssen, Merck, MSD, Pfizer. Astellas, Novartis. CC served as consultant for Pfizer, BMS, MSD, Janssen. SB served as consultant for Pfizer, BMS, MSD, Roche, Astellas, Janssen, Ipsen, Bayer, Sanofi-Genzyme, Merck, AstraZeneca. Travel accommodation from Pfizer, BMS, Roche, Astellas, Janssen, Ipsen, AstraZeneca. UDG served as consultant for Astellas, Bayer, BMS, Ipsen, Janssen, Merck, Pfizer and Sanofi; has received travel support from BMS, Ipsen, Janssen and Pfizer; and has received research funding from AstraZeneca, Roche and Sanofi (Inst). UB served as consultant for Advisory board BMS, MSD, Janssen. He received speaker's fees BMS, Ipsen, Janssen, Astellas. GT served as consultant for BMS and MSD. GP served as consultant for Astellas, Astra-Zeneca, Bayer, BMS, Ipsen, Janssen, Merck, MSD, Pfizer, Novartis, Sanofi. CC, MM. AF, LG, FM, AC, MGM, DB, FMD, MD, FP, FR declared not conflict of interests.
(Copyright © 2022. Published by Elsevier Inc.)
Databáze: MEDLINE
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