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Clinical outcomes of second-line treatment following prior targeted therapy in patients with metastatic renal cell carcinoma: a comparison of axitinib and nivolumab
- Source :
- International journal of clinical oncology. 25(9)
- Publication Year :
- 2020
-
Abstract
- Sequential treatment starting with target therapy is still the standard care for metastatic renal cell carcinoma (mRCC), even in the era of immune checkpoint inhibitors. Our objective was to compare the clinical outcomes between axitinib and nivolumab as second-line therapy following prior targeted therapy in mRCC patients. We identified 41 patients treated with axitinib and 39 patients treated with nivolumab as a second-line regimen after targeted therapy, and retrospectively compared the treatment efficacy and safety in these patients. The clinical benefit rate of axitinib was significantly higher than that of nivolumab (82.9% versus 56.4%; p = 0.014) and patients who received axitinib tended to show longer progression-free survival (PFS) than those who received nivolumab (10.3 months versus 7.3 months; p = 0.067). There was no difference in the overall survival (OS) of the two groups (both not reached; p = 0.581). The incidence of grade ≥ 3 adverse events (AEs) was similar between the two groups, but one patient in the nivolumab group died due to an immune-related AE. In addition, a Cox proportional hazards model showed that the pre-treatment KPS, the baseline neutrophil-to-lymphocyte ratio (NLR), and an objective response in second-line therapy were significantly associated with PFS, while the pre-treatment KPS, the number of metastatic organs, and an objective response in second-line therapy significantly contributed to the predicted OS. Although the prognosis did not differ markedly between the two groups, axitinib resulted in a better tumor response rate. Further randomized prospective studies are needed for the ideal order of this sequential treatment.
- Subjects :
- 0301 basic medicine
Oncology
Adult
Male
medicine.medical_specialty
Axitinib
medicine.medical_treatment
Antineoplastic Agents
Targeted therapy
03 medical and health sciences
0302 clinical medicine
Renal cell carcinoma
Internal medicine
Medicine
Humans
Adverse effect
Prospective cohort study
Carcinoma, Renal Cell
Aged
Proportional Hazards Models
Retrospective Studies
Aged, 80 and over
business.industry
Proportional hazards model
Hematology
General Medicine
Middle Aged
medicine.disease
Prognosis
Kidney Neoplasms
Progression-Free Survival
Regimen
030104 developmental biology
Nivolumab
Treatment Outcome
030220 oncology & carcinogenesis
Surgery
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 14377772
- Volume :
- 25
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- International journal of clinical oncology
- Accession number :
- edsair.doi.dedup.....ac257de94d5debc07db8756be8d886c2