Dual immune check point blockade or immune check point-tyrosine kinase inhibitor combination: as a first-line treatment in metastatic renal cell carcinoma?
Autor: | Jens Bedke, Shahrokh F. Shariat, Irene Resch, Mesut Remzi, Harun Fajkovic, Manuela Schmidinger |
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Rok vydání: | 2021 |
Předmět: |
Oncology
medicine.medical_specialty Axitinib Cabozantinib medicine.drug_class Urology 030232 urology & nephrology Ipilimumab Pembrolizumab Tyrosine-kinase inhibitor 03 medical and health sciences chemistry.chemical_compound Antineoplastic Agents Immunological 0302 clinical medicine Renal cell carcinoma Internal medicine medicine Humans Carcinoma Renal Cell Protein Kinase Inhibitors Sunitinib business.industry medicine.disease Kidney Neoplasms chemistry 030220 oncology & carcinogenesis Nivolumab business medicine.drug |
Zdroj: | Current Opinion in Urology. 31:270-275 |
ISSN: | 1473-6586 0963-0643 |
Popis: | Purpose of review To discuss treatment decisions in the first-line setting of metastatic renal cell carcinoma (mRCC). Recent findings Immune check point inhibitor (ICI) combinations have replaced sunitinib as the standard of care in the first-line treatment of mRCC. Dual ICI treatment with nivolumab and ipilimumab was shown to significantly improve overall survival and objective response rates. Similarly, the ICI-tyrosine kinase inhibitor combinations pembrolizumab and axitinib and nivolumab and cabozantinib have demonstrated superiority in terms of overall survival, objective response rates and progression-free survival versus sunitinib. The lack of both comparative trials and predictive markers impedes individualized treatment decisions. Clinicians are left to make treatment choices based on clinical and biological factors. These factors may include differences in toxicity profiles, the rate of complete remission, a clinical situation that requires urgent tumor shrinkage, the presence of inflammation, histological or immune-histochemical features and others. Summary In the absence of comparative trials, clinical and biological factors may facilitate the choice between various treatment options in the first-line setting of mRCC. In addition, both the experience of the physician with a specific treatment together with patient's preferences and expectations of systemic therapy may be part of the decision-making process. |
Databáze: | OpenAIRE |
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