Department of Radiology, Juravinski Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada.
Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), New Delhi 110085, India.
Tomography. 2022 May 20;8(3):1363-1373. doi: 10.3390/tomography8030110.
The purpose was to determine whether tumor response to CPI varies by organ and to characterize response patterns in a group of surgically treated metastatic RCC patients treated with Nivolumab. : A retrospective analysis was undertaken between January 2016 and March 2020 on patients receiving Nivolumab for metastatic RCC, following first-line therapy and having at least one baseline and two follow-up scans. A Fisher's exact test was used to compare categorical variables, and a Kruskal-Wallis test was used to compare continuous variables. Twenty-one out of thirty patients evaluated were eligible, and they were divided into two groups: responders (n = 11) and non-responders (n = 10). According to all iRECIST standards, 18 (85.7 percent) of the 21 patients had PD (10 patients), PR (3 patients), or SD (8 patients). At baseline, 7, 15, 4, 13, 7, and 7 patients, respectively, had detectable hepatic metastasis and lung, brain, lymph node, soft tissue, and other intra-abdominal metastases; these patients were evaluated for organ-specific response. The ORRs for hepatic metastasis and lung, brain, lymph node, soft tissue, adrenals, and other intraperitoneal metastases were correspondingly 10%, 20%, 35%, 0%, and 25%. In total, 13 (61.9%) of them demonstrated varied responses to CPI therapy, with 6 (28.5%) demonstrating intra-organ differential responses. The lymph nodes (35%) had the best objective response (BOR), followed by the adrenals and peritoneum (both 25%), the brain (20%), and the lung (20%). The response rate was highest in adrenal gland lesions (2/4; 50%), followed by lymph nodes (13/19; 68.4 percent) and liver (5/10; 50%), whereas rates were lowest for lesions in the lung (9/25; 36%), intraperitoneal metastases (1/4; 25%), and brain (1/5; 20%). : In renal cell carcinoma, checkpoint inhibitors have a variable response at different metastatic sites, with the best response occurring in lymph nodes and the least occurring in soft tissue.
目的是确定肿瘤对 CPI 的反应是否因器官而异，并描述一组接受纳武利尤单抗治疗的转移性肾细胞癌（RCC）患者的治疗后反应模式。 对 2016 年 1 月至 2020 年 3 月期间接受纳武利尤单抗治疗转移性 RCC 的患者进行了一项回顾性分析，这些患者接受了一线治疗，并且至少有基线和两次随访扫描。采用 Fisher 确切检验比较分类变量，采用 Kruskal-Wallis 检验比较连续变量。 在评估的 30 名患者中，有 21 名符合条件，他们被分为两组：应答者（n=11）和无应答者（n=10）。根据所有 iRECIST 标准，21 名患者中的 18 名（85.7%）出现 PD（10 名患者）、PR（3 名患者）或 SD（8 名患者）。基线时，分别有 7、15、4、13、7 和 7 名患者有可检测的肝转移和肺、脑、淋巴结、软组织和其他腹腔内转移；对这些患者进行了器官特异性反应评估。肝转移和肺、脑、淋巴结、软组织、肾上腺和其他腹膜内转移的 ORR 分别为 10%、20%、35%、0%和 25%。总共有 13 名患者（61.9%）对 CPI 治疗有不同的反应，其中 6 名患者（28.5%）有器官内的差异反应。淋巴结（35%）的客观缓解率（BOR）最好，其次是肾上腺和腹膜（均为 25%）、脑（20%）和肺（20%）。肾上腺病变的反应率最高（4/4；50%），其次是淋巴结（19/19；68.4%）和肝（10/10；50%），而肺病变（25/25；36%）、腹膜内转移（4/4；25%）和脑（5/5；20%）的反应率最低。 在肾细胞癌中，检查点抑制剂在不同的转移部位的反应不同，淋巴结的反应最好，软组织的反应最差。
