更新的欧洲泌尿外科学会肾癌指南:纳武利尤单抗联合卡博替尼加入免疫检查点抑制联合治疗用于治疗初治转移性透明细胞肾细胞癌。

Updated European Association of Urology Guidelines on Renal Cell Carcinoma: Nivolumab plus Cabozantinib Joins Immune Checkpoint Inhibition Combination Therapies for Treatment-naïve Metastatic Clear-Cell Renal Cell Carcinoma.

机构信息

Department of Urology, University Hospital Tuebingen, Tuebingen, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.

Department of Cancer Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France.

出版信息

Eur Urol. 2021 Mar;79(3):339-342. doi: 10.1016/j.eururo.2020.12.005. Epub 2020 Dec 24.

Abstract

Longer follow-up and new trial data from phase 3 randomised controlled trials investigating immune checkpoint blockade (PD-1 or its ligand PD-L1) in advanced clear-cell renal cell carcinoma (RCC) have recently become available. The CheckMate 9ER trial demonstrated an improved progression-free survival (PFS) and overall survival (OS) benefit for the combination of cabozantinib plus nivolumab. A Keynote-426 update demonstrated an ongoing OS benefit for pembrolizumab plus axitinib in the intention-to-treat population, with a PFS benefit seen across all International Metastatic Database Consortium (IMDC) subgroups, while an update of CheckMate 214 confirmed the long-term benefit of ipilimumab plus nivolumab in IMDC intermediate and poor risk patients. The RCC Guidelines Panel continues to recommend these tyrosine kinase inhibitors + immunotherapy (IO) combination across IMDC risk groups in advanced first-line RCC and dual immunotherapy of ipilimumab and nivolumab in IMDC intermediate and poor risk. PATIENT SUMMARY: New data from trials of immune checkpoint inhibitors for advanced kidney cancer confirm a survival benefit with the combination of cabozantinib plus nivolumab and pembrolizumab plus axitinib and ipilimumab plus nivolumab. These combination therapies are recommended as first-line treatment for advanced kidney cancer.

摘要

最近,来自 III 期随机对照临床试验的更长随访和新试验数据,调查了免疫检查点阻断(PD-1 或其配体 PD-L1)在晚期透明细胞肾细胞癌(RCC)中的应用。CheckMate 9ER 试验显示卡博替尼联合纳武利尤单抗可改善无进展生存期(PFS)和总生存期(OS)。一项 KeyNote-426 更新显示,在意向治疗人群中,帕博利珠单抗联合阿昔替尼持续有 OS 获益,在所有国际转移性数据库联盟(IMDC)亚组中均观察到 PFS 获益,而 CheckMate 214 的更新则证实了伊匹单抗联合纳武利尤单抗在 IMDC 中危和高危患者中的长期获益。RCC 指南小组继续建议在晚期一线 RCC 中,根据 IMDC 风险组,在酪氨酸激酶抑制剂+免疫治疗(IO)联合治疗中推荐这些方案,在 IMDC 中危和高危患者中推荐双重免疫治疗,即伊匹单抗和纳武利尤单抗。

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