La Vecchia Maria, Federico Manuela, Aiello Dario, Zagardo Valentina, Mazzonello Antonella, Testa Lorella, La Paglia Leonarda, Bruno Tiziana, Fazio Ivan
Unità Operativa di Radioterapia Oncologica, Casa di Cura Macchiarella, 90138 Palermo, Italy.
Unità Operativa di Radioterapia Oncologica, Rem Radioterapia srl, 95029 Viagrande, Italy.
J Pers Med. 2024 Sep 27;14(10):1030. doi: 10.3390/jpm14101030.
This multicentric, retrospective study investigated the use of stereotactic body radiotherapy (SBRT) in patients (pts) with metastatic renal cell carcinoma (mRCC) who experienced oligoprogression during a combination therapy with an immune checkpoint inhibitor (ICI) and a tyrosine-kinase inhibitor (TKI).
We retrospectively evaluated 34 pts affected by oligoprogressive RCC treated with an ICI-TKI combination between January 2020 and December 2023. SBRT was delivered to each site of oligoprogressive metastatic disease. After SBRT, pts were given follow-up clinical evaluations. 6-12-18-month local control (LC) rates and median next-line treatment-free survival (NEST-FS) were the primary endpoints. The secondary endpoints were overall response rate (ORR), clinical benefits and safety.
After a median follow-up of 24 months, 6-12-18-month LC rates were 100%, 71% and 43%, respectively, and the median NEST-FS was 20 months. ORR was 90%, while clinical benefit was 100%. No > G2 adverse events related to SBRT were recorded.
In our study, SBRT for oligoprogressive mRCC turned out to be a safe and useful treatment which was able to preserve current treatment. Further prospective studies are necessary to explore the effects of the ICIs-TKIs combination and SBRT upon oligoprogressive sites in mRCC.
本多中心回顾性研究调查了立体定向体部放疗(SBRT)在接受免疫检查点抑制剂(ICI)和酪氨酸激酶抑制剂(TKI)联合治疗期间出现寡进展的转移性肾细胞癌(mRCC)患者中的应用。
我们回顾性评估了2020年1月至2023年12月期间34例接受ICI-TKI联合治疗的寡进展性肾细胞癌患者。对每个寡进展性转移病灶部位进行SBRT治疗。SBRT治疗后,对患者进行随访临床评估。6个月、12个月和18个月的局部控制(LC)率以及中位下次无治疗生存期(NEST-FS)为主要终点。次要终点为总缓解率(ORR)、临床获益和安全性。
中位随访24个月后,6个月、12个月和18个月的LC率分别为100%、71%和43%,中位NEST-FS为20个月。ORR为90%,临床获益率为100%。未记录到与SBRT相关的>2级不良事件。
在我们的研究中,SBRT治疗寡进展性mRCC是一种安全有效的治疗方法,能够维持当前治疗。需要进一步的前瞻性研究来探索ICI-TKIs联合治疗和SBRT对mRCC寡进展部位的影响。