NIVO於轉移性腎細胞癌有其角色? 單一教學醫院之經驗
倪雪雰、洪晟鈞、李建儀
台中榮總 外科部 泌尿外科
Nivolumab (NIVO) in pretreated patients with metastatic renal cell carcinoma (mRCC), a single hospital experience
Hsueh-Fen Ni, Sheng-Chun Hung, Jian‐Ri Lee
Divisions of Urology, Department of Surgery, Taichung Veterans General Hospital
Purpose:
Combination treatments with immuno-oncology have been approved for first-line treatment of patients with metastatic renal cell carcinoma (mRCC). However while no local data was reported until now. We want to evaluated the efficacy of NIVO over our mRCC pts
Materials and Methods
In this retrospective review, 158 patient with metastatic renal cell carcinoma, since January 1, 2000 in Taichung Veterans General Hospital, was reviewed. Treatment beyond progression was allowed in patients who tolerated NIVO and experienced clinical benefit.
The primary endpoint was progression-free survival. Secondary endpoints were overall survival (OS), adverse event rate, and association of complete metastasectomy with clinical outcomes. Data cutoff, October 30, 2020
Results:
158 pts were enrolled from January 2000 to October 2020 in our single center. 20 patients under treatment combination with NIVO, and other 138 patients treated with other target therapy agent( including sunitinib, axitinib...), but without NIVO. 85% of pts treated with NIVO had clear cell histology, median age was 57 years, 70% were male. ECOG PS was 0 in 13 pts (65%). As for patient group without NIVO ,79% of pts had clear cell histology, median age was 57 years, 71% were male. ECOG PS was 0 in 89 pts (64.5%).Metastases occurred predominantly in lung (62%), lymph nodes (46%) and bone (35%). IMDC risk were: 0 (22%), 1 (62%), and 2 (15%), which were balanced between arms. OS over 96 months for with NIVO vs.target therapy without NIVO (49.24 vs.4.37%, P=0.056). PFS from randomization was 10.94 vs. 3.39 months.
Conclusions:
There are limited data about the efficacy of available therapies for mncRCC. Our study shows that combination of NIVO has significant improvement over efficacy compared to those patient group treated with target therapy without NIVO data in mRCC.