Comparison of real-world outcomes between nivolumab plus ipilimumab and lenvatinib plus pembrolizumab or nivolumab plus cabozantinib combination therapies for previously untreated advanced renal cell carcinoma

IF 2.3 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations Pub Date : 2025-08-05 DOI:10.1016/j.urolonc.2025.06.019

Hiroki Ishihara , Kenji Omae , Yuki Nemoto , Shinsuke Mizoguchi , Nanaka Katsurayama , Takayuki Nakayama , Hironori Fukuda , Kazuhiko Yoshida , Hiroaki Shimmura , Yasunobu Hashimoto , Junpei Iizuka , Tsunenori Kondo , Toshio Takagi

{"title":"Comparison of real-world outcomes between nivolumab plus ipilimumab and lenvatinib plus pembrolizumab or nivolumab plus cabozantinib combination therapies for previously untreated advanced renal cell carcinoma","authors":"Hiroki Ishihara , Kenji Omae , Yuki Nemoto , Shinsuke Mizoguchi , Nanaka Katsurayama , Takayuki Nakayama , Hironori Fukuda , Kazuhiko Yoshida , Hiroaki Shimmura , Yasunobu Hashimoto , Junpei Iizuka , Tsunenori Kondo , Toshio Takagi","doi":"10.1016/j.urolonc.2025.06.019","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Data regarding a direct comparison of outcomes between nivolumab plus ipilimumab (N-I) and lenvatinib plus pembrolizumab (L-P) or nivolumab plus cabozantinib (N<img>C) combination therapies for advanced renal cell carcinoma (RCC) are limited. We compared treatment outcomes between N-I and <span>L-P</span><em>/N</em><img>C in previously untreated advanced RCC.</div></div><div><h3>Methods</h3><div>The clinical data of 194 patients receiving N-I (<em>n</em> = 109) and <span>L-P</span>/N<img>C (<em>n</em> = 85) as first-line therapies for advanced RCC were retrospectively assessed.</div></div><div><h3>Results</h3><div>According to the inverse probability of treatment weighting analysis, progression-free survival (PFS) was longer (median: 26.0 vs. 9.0 months, <em>P</em> = 0.0024) and the objective response rate (ORR) was higher (61.4% vs. 45.6%, <em>P</em> = 0.031) in the <span>L-P</span>/N<img>C group than in the N-I group, whereas no significant difference was observed in overall survival between the groups (median: not reached vs. 56.0 months, <em>P</em> = 0.193). The rates of adverse events (AEs) (97.4% vs. 78.8%, <em>P</em> < 0.0001) and treatment interruption (70.5% vs. 51.1%, <em>P</em> = 0.007) were higher in the <span>L-P</span>/N<img>C group than in the N-I group. The rate of glucocorticoid requirement was higher in the N-I group than in the <span>L-P</span>/N<img>C group (43.8% vs. 27.5%, <em>P</em> = 0.023).</div></div><div><h3>Conclusion</h3><div><span>L-P</span>/N<img>C exhibited superior PFS and ORR compared with N-I in patients with advanced RCC. The <span>L-P</span>/N<img>C group harbored a higher risk of AEs and treatment withdrawal, whereas the rate of glucocorticoid requirement was higher in the N-I group. Understanding the outcome characteristics of each immuno-oncology combination therapy will help to provide optimal and individualized treatment strategies.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 10","pages":"Pages 598.e1-598.e10"},"PeriodicalIF":2.3000,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urologic Oncology-seminars and Original Investigations","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1078143925002601","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Data regarding a direct comparison of outcomes between nivolumab plus ipilimumab (N-I) and lenvatinib plus pembrolizumab (L-P) or nivolumab plus cabozantinib (NC) combination therapies for advanced renal cell carcinoma (RCC) are limited. We compared treatment outcomes between N-I and L-P/NC in previously untreated advanced RCC.

Methods

The clinical data of 194 patients receiving N-I (n = 109) and L-P/NC (n = 85) as first-line therapies for advanced RCC were retrospectively assessed.

Results

According to the inverse probability of treatment weighting analysis, progression-free survival (PFS) was longer (median: 26.0 vs. 9.0 months, P = 0.0024) and the objective response rate (ORR) was higher (61.4% vs. 45.6%, P = 0.031) in the L-P/NC group than in the N-I group, whereas no significant difference was observed in overall survival between the groups (median: not reached vs. 56.0 months, P = 0.193). The rates of adverse events (AEs) (97.4% vs. 78.8%, P < 0.0001) and treatment interruption (70.5% vs. 51.1%, P = 0.007) were higher in the L-P/NC group than in the N-I group. The rate of glucocorticoid requirement was higher in the N-I group than in the L-P/NC group (43.8% vs. 27.5%, P = 0.023).

Conclusion

L-P/NC exhibited superior PFS and ORR compared with N-I in patients with advanced RCC. The L-P/NC group harbored a higher risk of AEs and treatment withdrawal, whereas the rate of glucocorticoid requirement was higher in the N-I group. Understanding the outcome characteristics of each immuno-oncology combination therapy will help to provide optimal and individualized treatment strategies.

查看原文本刊更多论文

nivolumab + ipilimumab与lenvatinib + pembrolizumab或nivolumab + cabozantinib联合治疗先前未经治疗的晚期肾细胞癌的实际结果比较。

背景：关于nivolumab + ipilimumab （N-I）和lenvatinib + pembrolizumab （L-P）或nivolumab + cabozantinib （NC）联合治疗晚期肾细胞癌（RCC）的直接比较结果的数据有限。我们比较了N-I和L-P/NC在先前未治疗的晚期RCC中的治疗结果。方法：回顾性分析194例接受n - i（109例）和L-P/NC（85例）一线治疗的晚期RCC患者的临床资料。结果：根据治疗加权逆概率分析，L-P/NC组的无进展生存期（PFS）较N-I组更长（中位数：26.0 vs. 9.0个月，P = 0.0024），客观缓解率（ORR）较高（61.4% vs. 45.6%, P = 0.031），而两组总生存期无显著差异（中位数：未达到vs. 56.0个月，P = 0.193）。L-P/NC组不良事件发生率（97.4%比78.8%,P < 0.0001）和治疗中断率（70.5%比51.1%,P = 0.007）均高于N-I组。N-I组糖皮质激素需要率高于L-P/NC组（43.8%比27.5%,P = 0.023）。结论：与N-I相比，L-P/NC在晚期RCC患者中表现出更好的PFS和ORR。L-P/NC组有较高的不良反应和停药风险，而N-I组糖皮质激素需要率较高。了解每种免疫肿瘤联合治疗的结果特征将有助于提供最佳和个性化的治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Urologic Oncology-seminars and Original Investigations 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.70%

发文量

297

审稿时长

7.6 weeks

期刊介绍： Urologic Oncology: Seminars and Original Investigations is the official journal of the Society of Urologic Oncology. The journal publishes practical, timely, and relevant clinical and basic science research articles which address any aspect of urologic oncology. Each issue comprises original research, news and topics, survey articles providing short commentaries on other important articles in the urologic oncology literature, and reviews including an in-depth Seminar examining a specific clinical dilemma. The journal periodically publishes supplement issues devoted to areas of current interest to the urologic oncology community. Articles published are of interest to researchers and the clinicians involved in the practice of urologic oncology including urologists, oncologists, and radiologists.