卡博替尼治疗免疫检查点抑制剂治疗后的乳头状与透明细胞肾细胞癌的疗效。

Efficacy of Cabozantinib for Papillary Compared With Clear-cell Renal Cell Carcinoma Following Immune Checkpoint Inhibitor Treatment.

机构信息

Department of Urology, Saiseikai Kazo Hospital, Saitama, Japan.

Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Anticancer Res. 2022 Jun;42(6):3151-3158. doi: 10.21873/anticanres.15804.

DOI:10.21873/anticanres.15804

PMID:35641290

Abstract

BACKGROUND

The efficacy of combined immunotherapy for papillary renal cell carcinoma (pRCC) based on prolonged progression-free survival (PFS) and overall survival in several clinical trials remains unknown. We aimed to compare the efficacy of cabozantinib in patients with pRCC and those with clear-cell renal cell carcinoma (ccRCC).

PATIENTS AND METHODS

This retrospective study included 27 patients with metastatic RCC who received cabozantinib as second-line or later therapy between June 2020 and October 2021. Objective response, PFS, and toxicity were compared between the ccRCC and pRCC groups.

RESULTS

Out of 27 patients, seven and 20 were diagnosed with pRCC and ccRCC, respectively. Out of the seven patients with pRCC, cabozantinib was used as second-line treatment in four patients and as third-line treatment in three patients, and all seven patients had had prior immunotherapy. One and two patients achieved complete and partial responses, respectively; four patients had stable disease, and none had progressive disease. The rates of objective response (43% vs. 30%, p=0.65) and disease control (100% vs. 85%, p=0.54) were similarly high in patients with pRCC and ccRCC. Changes in the target lesions were -19% and -10% (p=0.11), respectively. With a median follow-up of 7.1 months, the median PFS tended to be longer in patients with pRCC than in those with ccRCC (not reached vs. 10.7 months, p=0.12). Discontinuation due to toxicity was observed in four (57%) patients with pRCC and 10 (50%) patients with ccRCC.

CONCLUSION

Cabozantinib is effective for pRCC, similar to ccRCC. This information may help physicians to select treatment options for pRCC.

摘要

背景

几项临床试验显示，联合免疫疗法可延长乳头状肾细胞癌（pRCC）患者的无进展生存期（PFS）和总生存期，但其疗效仍不清楚。我们旨在比较卡博替尼治疗 pRCC 患者和透明细胞肾细胞癌（ccRCC）患者的疗效。

患者和方法

这项回顾性研究纳入了 27 例 2020 年 6 月至 2021 年 10 月期间接受卡博替尼二线或后线治疗的转移性肾细胞癌患者。比较了 ccRCC 组和 pRCC 组的客观缓解率、PFS 和毒性。

结果

27 例患者中，7 例诊断为 pRCC，20 例诊断为 ccRCC。7 例 pRCC 患者中，4 例接受卡博替尼二线治疗，3 例接受三线治疗，且所有患者均接受过免疫治疗。1 例和 2 例患者分别获得完全缓解和部分缓解；4 例患者疾病稳定，无进展性疾病。pRCC 患者和 ccRCC 患者的客观缓解率（43% vs. 30%，p=0.65）和疾病控制率（100% vs. 85%，p=0.54）均较高。靶病灶变化率分别为-19%和-10%（p=0.11）。中位随访 7.1 个月时，pRCC 患者的中位 PFS 长于 ccRCC 患者（未达到 vs. 10.7 个月，p=0.12）。pRCC 患者中有 4 例（57%）因毒性而停药，ccRCC 患者中有 10 例（50%）因毒性而停药。