Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Department of Urology, Hamamatsu University School of Medicine, Shizuoka, Japan.
Int J Clin Oncol. 2024 Dec;29(12):1931-1936. doi: 10.1007/s10147-024-02633-w. Epub 2024 Oct 30.
Combined treatment with lenvatinib and pembrolizumab is currently regarded as one of the standard first-line therapies for advanced renal cell carcinoma (aRCC) patients. The objective of this study was to assess the efficacy and safety of this combined regimen in treatment-naïve Japanese aRCC patients.
This study included a total of 50 consecutive aRCC patients receiving combined lenvatinib plus pembrolizumab in routine clinical practice in Japan, and comprehensively analyzed clinical outcomes of this treatment.
Of these 50, 7 (14.0%), 23 (46.0%) and 20 (40.0%) were classified into favorable, intermediate and poor risk groups, respectively, according to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) system. Responses to this combined therapy in the 50 patients were as follows: complete response, 7 (14.0%); partial response, 26 (52.0%); stable disease, 15 (30%) and progressive disease, 2 (4%); thus, the objective response rate (ORR) was 66%. ORRs in favorable, intermediate and poor risk groups were 57.1, 69.6 and 65.0%, respectively. During the observation period, disease progression and death occurred in 14 (28.0%) and 6 (12.0%) patients, respectively, and neither the median PFS nor OS was reached. Adverse events and those corresponding to grade ≥ 3 were observed in all (100%) and 33 (66.0%) patients, respectively.
To our knowledge, this is the first study focusing on real-world outcomes of lenvatinib and pembrolizumab for treatment-naïve aRCC patients, showing that the efficacy and safety of this combined regimen are similar to those noted in randomized clinical trial.
仑伐替尼联合帕博利珠单抗目前被认为是晚期肾细胞癌(aRCC)患者的标准一线治疗之一。本研究旨在评估该联合方案在未经治疗的日本 aRCC 患者中的疗效和安全性。
本研究共纳入 50 例连续接受仑伐替尼联合帕博利珠单抗治疗的初治日本 aRCC 患者,对该治疗方案的临床结局进行综合分析。
根据国际转移性肾细胞癌数据库联盟(IMDC)系统,这 50 例患者中,7 例(14.0%)、23 例(46.0%)和 20 例(40.0%)分别为有利、中等和不良风险组。50 例患者对联合治疗的反应如下:完全缓解 7 例(14.0%),部分缓解 26 例(52.0%),稳定疾病 15 例(30%),进展性疾病 2 例(4%),客观缓解率(ORR)为 66%。有利、中等和不良风险组的 ORR 分别为 57.1%、69.6%和 65.0%。在观察期间,14 例(28.0%)患者出现疾病进展,6 例(12.0%)患者死亡,中位无进展生存期(PFS)和总生存期(OS)均未达到。所有患者均出现不良事件(100%),33 例(66.0%)患者出现≥3 级不良事件。
据我们所知,这是第一项针对未经治疗的 aRCC 患者使用仑伐替尼联合帕博利珠单抗的真实世界研究,结果表明该联合方案的疗效和安全性与随机临床试验中观察到的相似。