進展或轉移性性非亮細胞腎臟癌的不同藥物治療策略之分析

曾義翔^1,3 黃逸修^1,3 黃子豪^1,3 魏子鈞^1,3 黃奕燊^1,3 林子平^1,3 鍾孝仁^1,3

張延驊^1,3 黃志賢^1,3 賴峻毅² 張牧新² 顏厥全²

台北榮民總醫院 ¹泌尿部 ²腫瘤醫學部

³國立陽明交通大學醫學院泌尿學科及書田泌尿科學研究中心

Efficacy assessment of different treatment strategies in advance/metastatic non-clear cell renal cell carcinoma

I-Hsiang Tseng^1,3, Eric Yi-Hsiu Huang^1,3, Tzu-Hao Huang^1,3, Tzu-Chun Wei^1,3,

I-Shen Huang^1,3, Tzu-Ping Lin^1,3, Hsiao-Jen Chung^1,3, Yen-Hwa Chang^1,3, William JS Huang^1,3, Jiun-I Lai², Mu-Hsin Chang², Chueh-Chuan Yen²,    

¹Department of Urology, ²Department of Oncology,

Taipei Veterans General Hospital

 ³Department of Urology, College of Medicine and ShuTien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

Purpose:

We evaluated the effectiveness of various treatment strategies for patients with advanced/metastatic non-clear cell renal cell carcinoma (nccRCC) at a single institute.

Materials and Methods:

We enrolled 55 patients with stage 4 nccRCC between January 2013 and January 2023 at our institute. Patients received various medications, including tyrosine kinase inhibitors (TKIs), mammalian target of rapamycin (mTOR) inhibitors, Programmed death-1 and Programmed death ligand 1 (PD1/PDL1) inhibitors, cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) inhibitors, and combinations such as TKI plus TKI, TKI plus PDL1/PD1, CTLA-4 plus PDL1/PD1 and chemotherapy regimens. We divide medication groups into seven major groups: TKIs, mTOR, PD1/PDL1, TKI plus TKI, TKI plus PDL1/PD1, CTLA-4 plus PDL1/PD1, and chemotherapy regiment.

Progression-free survival (PFS) and overall survival (OS) of seven group were analyzed. The complete response rates (CRRs), objective response rates (ORRs), grade ≥3 treatment-related adverse events (TRAEs), and rates of treatment discontinuation due to adverse events (AEs) were also analyzed.

Results:

After screening, a total of 55 patients with an average age of 57.5 years were included in the study, comprising 40 males and 15 females. The histological subtypes were as follows: 16 patients were papillary RCC, 7 patients were chromophobe RCC , 7 patients were Fumarate hydratase-deficient renal cell carcinoma, 7 patients were unclassified , 5 patients were collecting duct carcinoma, 4 patients were Xp 11.2 translocation carcinomas, 4 patients were MiT family translocation renal cell carcinoma , and 5 patients were in other group.

The mean PFS and OS over the 55 patients were 15.18 and 20.66 months.

The mean PFS and OS was not statistically different between the 7 groups.

Conclusion:

There were no statistically significant differences in mean PFS and OS among 7 treatment groups. The observed very modest efficacy underscores the need to develop more effective therapies for non-clear cell RCC.