转移性肾细胞癌:同步与异时转移性疾病及其对io联合时代癌症控制的影响——来自多机构队列的真实世界经验

IF 2.4 3区 医学 Q3 ONCOLOGY
Benedikt Hoeh, Cristina Cano Garcia, Angelika Mattigk, Marcus Sondermann, Niklas Klümper, Alexander Cox, Oliver Hahn, Jonathan Vollemaere, Kati Erdmann, Philipp Schmucker, Luka Flegar, Friedemann Zengerling, Severine Banek, Jörg Ellinger, Johannes Huber, Philip Zeuschner, Charis Kalogirou
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引用次数: 0

摘要

目的:转移性肾细胞癌(mRCC)的转移时间(同步与非同步)与免疫肿瘤学(IO)联合治疗时代的生存结果的关系尚未得到很好的理解。以IO联合治疗的mRCC患者转移时间为基础评估无进展生存期(PFS)和总生存期(OS)。材料和方法:来自多中心回顾性德国患者队列的数据用于比较同步转移(发生在癌症初始诊断后3个月内)和异时转移(4-24个月vs.≥25个月)。采用Kaplan-Meier曲线分析PFS和OS。Cox多变量回归分析调整基线特征。结果:该队列包括381例接受一线io联合治疗的mRCC患者,根据转移发作时间分类:167例(44%)在0-3个月,94例(25%)在4至24个月,120例(31%)在≥25个月。注意到初始诊断年龄,ECOG表现状态,局部肾脏治疗和全身治疗类型的差异(均P 结论:在接受io联合治疗的mRCC患者的当代队列中,转移性疾病的时间和开始全身治疗与OS相关。患者总结:本研究考察了转移发生时间对接受一线免疫联合治疗的肾癌患者生存结果的影响。研究结果表明,转移发生前的时间间隔越长,预后越好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Metastatic renal cell carcinoma: Synchronous vs. metachronous metastatic disease and its impact on cancer control in the IO-combination era-Real world experiences from a multi-institutional cohort.

Purpose: The association of metastatic timing (synchronous vs. metachronous) in metastatic renal cell carcinoma (mRCC) with survival outcomes in the immunooncology (IO) combination therapy era is not well understood to date. To assess progression-free survival (PFS) and overall survival (OS) based on the time to metastasis in mRCC patients treated with IO therapy combination therapies.

Material and methods: Data from a multi-center retrospective German patient cohort was used to compare synchronous metastasis (occurring within 3 months of the initial cancer diagnosis) with metachronous metastasis (4-24 months vs. ≥25 months). PFS and OS were analyzed using Kaplan-Meier curves. Cox multivariable regression analyses were adjusted for baseline characteristics.

Results: The cohort comprised 381 mRCC patients treated with 1st-line IO-combination therapies, categorized by time of metastatic onset: 167 (44%) in 0-3 months, 94 (25%) in 4 to 24 months, and 120 (31%) in ≥25 months. Differences in initial diagnosis age, ECOG performance status, local kidney treatment, and systemic treatment type were noted (all P < 0.05). Median PFS was 10.6 months for 0 to 3 months, 13.8 months for 4 to 24 months, and 16.8 months for ≥25 months (log-rank test: P = 0.028). Here, ≥25 months group showed significantly prolonged PFS in univariable (HR: 0.63; 95% CI:0.45-0.83) and multivariable Cox regression (HR: 0.64; 95% CI:0.41-0.99). Median OS was 28.0 months for 0 to 3 months, 39.7 months for 4 to 24 months, and 49.3 months for ≥25 months (P < 0.001). Multivariable Cox regression showed prolonged OS for both 4 to 24 months (HR: 0.45; 95% CI:0.26-0.76) and ≥25 months (HR: 0.56; 95% CI:0.33-0.95).

Conclusions: Within this contemporary cohort of mRCC patients treated with IO-combination therapy, timing of metastatic disease and initiation of systemic treatment was associated with OS.

Patient summary: This study examined the impact of when metastases occur on survival outcomes in kidney cancer patients treated with first-line immune-combination therapies. The findings show that a longer interval before the development of metastases is associated with better outcomes.

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来源期刊
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.
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