Imaging Response to Contemporary Immuno-oncology Combination Therapies in Patients With Metastatic Renal Cell Carcinoma

Abstract

Key Points Question Do contemporary first-line therapy options for metastatic renal cell carcinoma (mRCC) have different likelihoods of objective imaging response (complete or partial response), and is objective imaging response associated with overall survival? Findings In this cohort study involving 899 patients with mRCC, treatment with immune checkpoint blockade plus vascular endothelial growth factor receptor inhibitor combination therapies was more likely to be associated with objective imaging response than doublet immune checkpoint blockade therapy after adjustment for baseline demographic and clinical characteristics, including International Metastatic Renal Cell Carcinoma Database Consortium risk criteria. Objective imaging response was associated with improvement in overall survival among patients receiving both types of therapy. Meaning This study’s findings suggest that combination therapies with first-line immune checkpoint blockade plus vascular endothelial growth factor receptor inhibitor were more likely to be associated with objective imaging response than doublet immune checkpoint blockade therapy.

RETRACTED: Meta analysis of clinical prognosis of radiofrequency ablation versus partial nephrectomy in the treatment of early renal cell carcinoma

“…The exclusion criteria are as follows: (1) solitary kidney, multiple renal cell carcinoma; (2) Patients with distant metastasis and lymph node metastasis; (3) Patients with history of nephrectomy or partial nephrectomy; (4) Patients with other cancers; (5) Literatures with small sample size(n ≤ 3) and repeated reports.…”

Update on combined immunotherapy for the treatment of advanced renal cell carcinoma

“…The lack of any predictive biomarker further poses a challenge in this context. Certain factors that can be considered include 1 IMDC risk category, 2 sarcomatoid differentiation, 3 toxicity profile, 4 performance status, 5 intolerance or lack of affordability of oral medications, 6 cardiovascular comorbidities, 7 history of autoimmune disease, 8 anticipated patient compliance, and 9 availability of a clinical trial.…”

“…This study aims to compare two triplet therapies with doublet therapy (pembrolizumab/lenvatinib). The two triplet arms constitute 1 pembrolizumab plus lenvatinib plus belzutifan [a Hypoxia-Inducible Factor (HIF) antagonist] and 2 pembrolizumab plus lenvantinib plus quavonlimab (CTLA-4 antagonist). This trial will test the safety and efficacy of the HIF and CTLA-4 triplets when compared to doublet regimen.…”

“…Currently, there are various IO treatment options in the first-line setting as the standard of care, including doublet immune checkpoint blockade (ICB) therapy or ICB with VEGF receptor inhibitor [IO-tyrosine kinase inhibitor (TKI)]. 1 This has led to a significant improvement in clinical outcomes and disease prognosis. All approved combinations are superior to the historical standard of TKI monotherapy.…”

The role of cytoreductive nephrectomy in the immuno-oncological therapy era

“…Harnessing data from the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC), Navani et al [14] evaluated 1085 patients with metastatic RCC who received first-line immunotherapy combination therapies. On multivariable analysis, receipt of cytoreductive nephrectomy [odds ratio (OR): 1.59, 95% CI: 1.04-2.43, P ¼ 0.03] and favourable risk IMDC risk (OR: 1.93, 95% CI: 1.10-3.39, P ¼ 0.02) were associated with an increased likelihood of radiologic partial or complete response to therapy.…”