Comparison of the impacts of immune-related adverse events on the prognosis of patients with advanced renal cell carcinoma between patients treated with io-io and io-tki combination therapy

You have accessJournal of UrologyCME1 Apr 2023MP28-10 COMPARISON OF THE IMPACTS OF IMMUNE-RELATED ADVERSE EVENTS ON THE PROGNOSIS OF PATIENTS WITH ADVANCED RENAL CELL CARCINOMA BETWEEN PATIENTS TREATED WITH IO-IO AND IO-TKI COMBINATION THERAPY Hiroki Ishihara, Yuki Nemoto, Kazutaka Nakamura, Hidekazu Tachibana, Hironori Fukuda, Kazuhiko Yoshida, Hirohito Kobayashi, Junpei Iizuka, Hiroaki Shimmura, Yasunobu Hashimoto, Tsunenori Kondo, and Toshio Takagi Hiroki IshiharaHiroki Ishihara More articles by this author , Yuki NemotoYuki Nemoto More articles by this author , Kazutaka NakamuraKazutaka Nakamura More articles by this author , Hidekazu TachibanaHidekazu Tachibana More articles by this author , Hironori FukudaHironori Fukuda More articles by this author , Kazuhiko YoshidaKazuhiko Yoshida More articles by this author , Hirohito KobayashiHirohito Kobayashi More articles by this author , Junpei IizukaJunpei Iizuka More articles by this author , Hiroaki ShimmuraHiroaki Shimmura More articles by this author , Yasunobu HashimotoYasunobu Hashimoto More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , and Toshio TakagiToshio Takagi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003256.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Several studies have highlighted the prognostic impact of immune-related adverse events (irAEs) in patients with solid cancers including renal cell carcinoma (RCC) treated with immune checkpoint inhibitors (ICIs). However, similar data in patients with advanced RCC treated with ICI-based combination therapy as first-line therapy are scarce. METHODS: We retrospectively evaluated the data of 148 patients with advanced RCC receiving either ICI-dual combination therapy (i.e., IO-IO) or ICI plus tyrosine kinase inhibitor (TKI) combination therapy (i.e., IO-TKI) as first-line therapy at our affiliated institutions. Between the IO-IO and IO-TKI regimens groups, progression-free survival (PFS), overall survival (OS), and objective response rates (ORRs) were compared. RESULTS: Overall, a significantly higher proportion of patients experienced at least one irAEs during treatment in the IO-IO than in the IO-TKI group [67/91 (74%) vs. 30/57 (53%), respectively; p=0.0126]. PFS (median: 11.8 vs. 2.50 months, p<0.0001), OS (median: not reached vs. 31.0 months, p=0.0102), and ORR (55% vs. 17%, p=0.0028) were significantly superior in patients with irAEs than in those without irAEs in the IO-IO group (Figure 1). Multivariate analyses further showed that irAE development was an independent prognostic factor for longer PFS (hazard ratio: 0.25, p<0.0001) and OS (hazard ratio: 0.42, p=0.0287) in the IO-IO group. Contrarily, irAE development was not associated with PFS (median: 37.9 vs. 16.1 months, p=0.894), OS (not reached vs. not reached, p=0.846), or ORR (53% vs. 56%, p=0.539) in the IO-TKI group (Figure 2). CONCLUSIONS: In the first-line setting of systemic therapy for advanced RCC, the IO-IO regimen was associated with a higher incidence rate of irAEs than the IO-TKI regimen. Depending on the regimen used, the prognostic impact of irAEs might be different, even though we need appropriate optimal treatment for irAEs regardless of the regimens. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e373 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hiroki Ishihara More articles by this author Yuki Nemoto More articles by this author Kazutaka Nakamura More articles by this author Hidekazu Tachibana More articles by this author Hironori Fukuda More articles by this author Kazuhiko Yoshida More articles by this author Hirohito Kobayashi More articles by this author Junpei Iizuka More articles by this author Hiroaki Shimmura More articles by this author Yasunobu Hashimoto More articles by this author Tsunenori Kondo More articles by this author Toshio Takagi More articles by this author Expand All Advertisement PDF downloadLoading ...