Martina Catalano, Giulia Venturi, Alessia Salfi, Francesco Bloise, Federico Paolieri, Luca Galli, Michele Sisani, Laura Doni, Giandomenico Roviello
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引用次数: 0
Abstract
Background: Immune (IO)-combination therapies have revolutionized the treatment of advanced renal cell carcinoma (aRCC) but are more frequently associated with adverse events (AEs) compared to tyrosine kinase inhibitors (TKI) alone. This retrospective study aimed to evaluate the incidence and prognostic significance of AEs in patients receiving combination therapies.
Methods: We included patients treated with nivolumab/ipilimumab (NI), nivolumab/cabozantinib (NC), or pembrolizumab/axitinib (PA) at four Italian oncology centers between November 2023 and June 2024. The impact of AEs on progression-free survival (PFS), overall survival (OS), overall response, and disease control rate were analyzed using descriptive statistics, Kaplan-Meier method, and Cox regression.
Results: AEs occurred in 78.8% of NI, 87.9% of NC, and 92.3% of PA patients. Grade 3-4 AEs were more common in IO-TKI vs. IO-IO combinations (32.9% vs. 15.1%, p = 0.05). Pruritus and pulmonary events were more frequent with IO-IO, while hypertension and mucositis were more common with IO-TKI. High-grade AEs did not impact PFS or OS, but TKI reduction due to AEs was associated with longer OS (p < 0.01). Steroid use also improved OS (p = 0.04).
Conclusion: AEs are common in ICI-based therapies for RCC. While they do not negatively affect survival, their management, especially through dose reductions or steroids, may improve outcomes.
期刊介绍:
Many aspects of the immune system and mechanisms of immunomodulatory therapies remain to be elucidated in order to exploit fully the emerging opportunities. Those involved in the research and clinical applications of immunotherapy are challenged by the huge and intricate volumes of knowledge arising from this fast-evolving field. The journal Immunotherapy offers the scientific community an interdisciplinary forum, providing them with information on the most recent advances of various aspects of immunotherapies, in a concise format to aid navigation of this complex field.
Immunotherapy delivers essential information in concise, at-a-glance article formats. Key advances in the field are reported and analyzed by international experts, providing an authoritative but accessible forum for this vitally important area of research. Unsolicited article proposals are welcomed and authors are required to comply fully with the journal''s Disclosure & Conflict of Interest Policy as well as major publishing guidelines, including ICMJE and GPP3.