Systemic Analysis and Review of Nivolumab-ipilimumab Combination as a Rescue Strategy for Renal Cell Carcinoma After Treatment With AntiePD-1/PD-L1 Therapy.

Autor: Carril-Ajuria, Lucia, Lora, David, Carretero-González, Alberto, Martín-Soberón, Maricruz, Rioja-Viera, Patricia, Castellano, Daniel, de Velasco, Guillermo
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Zdroj: Clinical Genitourinary Cancer; Apr2021, Vol. 19 Issue 2, p95-102, 8p
Abstrakt: Nivolumab-ipilimumab has become the standard of care in the frontline setting for intermediate-/poor-risk metastatic renal cell carcinoma (mRCC). This regimen is associated with survival improvement but significant toxicity. Antiprogrammed cell death protein 1(PD-1)/programmed death-ligand 1(PD-L1) monotherapy may provide response and offers a better safety profile. In this context, nivolumab-ipilimumab has been postulated as a rescue treatment after antiePD-1/PD-L1 therapy. Recent retrospective data has shown positive results, and several nonrandomized clinical trials (NRCTs) have evaluated this strategy. Therefore, we performed a meta-analysis of available NRCTs to clarify the efficacy and safety of salvage nivolumab-ipilimumab in mRCC after prior antiePD-1/PD-L1 monotherapy. We searched PubMed, Medline, Embase, and the Cochrane Central Register of Controlled Trials to identify clinical trials investigating the efficacy and safety of salvage nivolumab-ipilimumab after prior antiePD-1/PD-L1 in patients with mRCC. Only phase II NRCTs were available for the analysis. The pooled effect of single proportions with a 95% confidence interval (CI) was used as the measure of effect (overall response rate [ORR] and incidence of grade x 3 adverse events). Four studies accounting for 237 patients were included. All patients received prior antiePD-1/PD-L1 monotherapy. The pooled ORR of salvage nivolumab-ipilimumab after prior antiePD-1/PD-L1 failure was 10.0% (95% CI, 6%-14%; I2 = 41%; P = .17). The incidence of grade ≥ 3 irAEs was 27.0% (95% CI, 20%-35%; I2 = 0%; P = .56). The results of this analysis suggest that the use of salvage nivolumab-ipilimumab in mRCC after prior antiePD-1/PDL1 has limited activity with a 10% ORR, and a non-negligible toxicity with 1 of 4 patients developing grade x 3 immune-related adverse events. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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