Comparative Effectiveness of Front-Line Ipilimumab and Nivolumab or Axitinib and Pembrolizumab in Metastatic Clear Cell Renal Cell Carcinoma.

Autor:	Zarrabi, Kevin K, Handorf, Elizabeth, Miron, Benjamin, Zibelman, Matthew R, Anari, Fern, Ghatalia, Pooja, Plimack, Elizabeth R, Geynisman, Daniel M
Předmět:	THERAPEUTIC use of monoclonal antibodies RENAL cell carcinoma SCIENTIFIC observation CONFIDENCE intervals PROTEIN kinase inhibitors LOG-rank test METASTASIS IPILIMUMAB RETROSPECTIVE studies TREATMENT effectiveness T-test (Statistics) NIVOLUMAB SURVIVAL analysis (Biometry) DESCRIPTIVE statistics CHI-squared test KAPLAN-Meier estimator DATA analysis software LOGISTIC regression analysis ODDS ratio IMMUNOTHERAPY
Zdroj:	Oncologist; Feb2023, Vol. 28 Issue 2, p157-164, 8p, 1 Diagram, 4 Charts, 2 Graphs
Abstrakt:	Background: Treatment of metastatic renal cell carcinoma (mRCC) is rapidly evolving with new combination therapies demonstrating improved response rates and survival. There are no head-to-head prospective trials comparing an immunotherapy doublet with an immunotherapy/tyrosine-kinase inhibitor-based combination. We compare real-world outcomes in patients treated with axitinib/pembrolizumab (axi/pembro) or ipilimumab/nivolumab (ipi/nivo). The primary endpoints were overall-survival (OS) and real-world progression-free survival (rwPFS). Patients and Methods: We used a de-identified database to select patients diagnosed with clear cell mRCC and treated with front-line axi/pembro or ipi/nivo from 2018 to 2022. Analyses are adjusted using propensity score-based inverse probability of treatment weighting, balancing age, gender, insurance, race, IMDC risk, and nephrectomy status. We compared survival by treatment groups using weighted and unweighted Kaplan–Meier curves with log-rank tests and weighted Cox proportional hazards regressions. Results: We included a total of 1506 patients with mRCC who received frontline axi/pembro (n = 547) or ipi/nivo (n = 959). Median follow-up time was 20.0 months (range: 0.2-47.6). Baseline demographics were similar between the 2 cohorts. Adjusted median OS for the full population was 28.9 months for axi/pembro and was 24.3 months for ipi/nivo (P =.09). Twenty-four-month survival was 53.8% for axi/pembro treated patients and 50.2% for ipi/nivo treated patients. rwPFS was 10.6 months for axi/pembro treated patients and 6.9 months for ipi/nivo treated patients. Treatment with axi/pembro conferred improved survival in the IMDC favorable risk strata, with no significant difference in survival observed within the full cohort. Conclusions: In this retrospective, real-world study of patients treated with front-line combination therapy, patients with IMDC favorable risk disease had better survival when treated with axi/pembro compared to ipi/nivo. However, survival for the entire population and the 24-month median overall survival were not statistically different between treatment groups. Longer follow-up is necessary to discern any emerging significant differences. This article reports real-world outcomes of patients with metastatic renal cell carcinoma treated with combination therapies (either axitinib/pembrolizumab or ipilimumab/nivolumab).] [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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