• Int. J. Clin. Oncol. · Jan 2021

    Multicenter Study

    Comparison of nivolumab plus ipilimumab with tyrosine kinase inhibitors as first-line therapies for metastatic renal-cell carcinoma: a multicenter retrospective study.

    • Koichi Kido, Shingo Hatakeyama, Kazuyuki Numakura, Toshikazu Tanaka, Masaaki Oikawa, Daisuke Noro, Shogo Hosogoe, Shintaro Narita, Takamitsu Inoue, Takahiro Yoneyama, Hiroyuki Ito, Shoji Nishimura, Yasuhiro Hashimoto, Toshiaki Kawaguchi, Tomonori Habuchi, and Chikara Ohyama.
    • Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
    • Int. J. Clin. Oncol. 2021 Jan 1; 26 (1): 154-162.

    BackgroundThis study compared real-world outcomes of metastatic renal-cell carcinoma (mRCC) patients treated with tyrosine kinase inhibitors or nivolumab plus ipilimumab.MethodsUsing the International mRCC Database Consortium (IMDC), we retrospectively evaluated intermediate- and poor-risk mRCC patients who were treated with nivolumab plus ipilimumab (Nivo-Ipi), tyrosine kinase inhibitors (TKIs) as the first-line therapy between August 2015 and January 2020. We compared oncological outcomes between the Nivo-Ipi group and TKIs group using multivariate logistic regression analysis with the inverse probability of treatment weighting (IPTW) method.ResultsIn this study 278 patients were included. There were 52 and 226 patients in the Nivo-Ipi and TKIs groups (sunitinib 97, axitinib 118, sorafenib 9, pazopanib 2), respectively. The median age in the Nivo-Ipi and TKIs groups were 69 and 67 years, respectively. There was no significant difference in age, performance status, history of nephrectomy, and the IMDC risk group distribution between the groups. The objective response rate was significantly higher in the Nivo-Ipi group (38%) than in the TKIs group (23%, P = 0.018). The IPTW-adjusted Cox regression analysis showed that a significantly longer progression-free survival (hazard ratio 0.60, P = 0.039) and overall survival (hazard ratio 0.51, P = 0.037) rates in the Nivo-Ipi group than those in the TKIs group.ConclusionsThe oncological outcomes of patients receiving the first-line therapy of nivolumab plus ipilimumab in real-world practice were significantly improved in comparison with first-line TKIs therapy.

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