1. Ilixadencel, a Cell-based Immune Primer, plus Sunitinib Versus Sunitinib Alone in Metastatic Renal Cell Carcinoma : A Randomized Phase 2 Study
- Author
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Lindskog, Magnus, Laurell, Anna, Kjellman, Anders, Melichar, Bohuslav, Rey, Pablo Maroto, Zielinski, Henryk, Villacampa, Felipe, Bigot, Pierre, Zoltan, Bajory, Parikh, Omi, Alba, David Vazquez, Jellvert, Dsa, Flasko, Tibor, Gallardo, Enrique, Caparros, Maria Jose Ribal, Purkalne, Gunta, Suenaert, Peter, Karlsson-Parra, Alex, Ljungberg, Borje, Lindskog, Magnus, Laurell, Anna, Kjellman, Anders, Melichar, Bohuslav, Rey, Pablo Maroto, Zielinski, Henryk, Villacampa, Felipe, Bigot, Pierre, Zoltan, Bajory, Parikh, Omi, Alba, David Vazquez, Jellvert, Dsa, Flasko, Tibor, Gallardo, Enrique, Caparros, Maria Jose Ribal, Purkalne, Gunta, Suenaert, Peter, Karlsson-Parra, Alex, and Ljungberg, Borje
- Abstract
Background: The prognosis of patients with synchronous metastatic renal cell carcinoma (mRCC) is poor. Whereas single-agent tyrosine kinase inhibition (TKI) is clearly insufficient, the effects can be enhanced by combinations with immune checkpoint inhibitors. Innovative treatment options combining TKI and other immune-stimulating agents could prove beneficial. Objective: To evaluate the clinical effects on metastatic disease when two doses of allogeneic monocyte-derived dendritic cells (ilixadencel) are administrated intratumorally followed by nephrectomy and treatment with sunitinib compared with nephrectomy and sunitinib monotherapy, in patients with synchronous mRCC. Design, setting, and participants: A randomized (2:1) phase 2 multicenter trial enrolled 88 patients with newly diagnosed mRCC to treatment with the combination ilixadencel/sunitinib (ILIXA/SUN; 58 patients) or sunitinib alone (SUN; 30 patients).Outcome measurements and statistical analysis: The primary endpoints were 18mo survival rate and overall survival (OS). A secondary endpoint was objective response rate (ORR) assessed up to 18 mo after enrollment. Statistic evaluations included Kaplan-Meier estimates, log-rank tests, Cox regression, and stratified Cochran-Mantel-Haenszel tests.Results and limitations: The median OS was 35.6 mo in the ILIXA/SUN arm versus 25.3 mo in the SUN arm (hazard ratio 0.73, 95% confidence interval 0.42-1.27; p = 0.25), while the 18-mo OS rates were 63% and 66% in the ILIXA/SUN and SUN arms, respectively. The confirmed ORR in the ILIXA/SUN arm were 42.2% (19/45), including three patients with complete response, versus 24.0% (six/25) in the SUN arm (p = 0.13) without complete responses. The study was not adequately powered to detect modest differences in survival. Conclusions: The study failed to meet its primary endpoints. However, ilixadencel in combination with sunitinib was associated with a numerically higher, nonsignificant, confirmed response rate, including compl
- Published
- 2022
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