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Background <p>Data on the impact of first-line immune checkpoint inhibitor (ICI) combination therapy regimen on the outcomes of second-line tyrosine kinase inhibitor (TKI) treatment for advanced renal-cell carcinoma (RCC) remain limited.</p> Methods <p>We retrospectively evaluated data from 105 patients who discontinued first-line ICI combination therapy. Progression-free survival (PFS) after second-line TKI treatment and PFS2, defined as the sum of PFS during first-line and second-line therapies, were compared between patients who received dual ICI combination therapy (i.e., immunotherapy [IO]–IO) and those who received a combination of ICI and TKI (i.e., IO–TKI).</p> Result <p>Of the 105 patients, 66 (63%) and 39 (37%) were treated with first-line IO–IO and IO–TKI combination therapy, respectively. The conversion rate to second-line therapy was higher in the IO–IO treatment group than in the IO–TKI group (73 vs. 54%, <i>p</i> = 0.0489). Sixty-six patients received second-line TKI treatment, and second-line PFS was longer in the IO–IO treatment group than in the IO–TKI group (median: 12.1 vs. 6.3&#xa0;months, <i>p</i> = 0.0048). Additionally, PFS2 was longer in the IO–IO treatment group than in the IO–TKI group (median: 19.7 vs. 15.4&#xa0;months, <i>p</i> = 0.0416). After adjusting for other covariates, the first-line treatment regimen (i.e., IO–IO vs. IO–TKI) was identified as an independent factor for PFS2 (HR: 0.51, <i>p</i> = 0.0057).</p> Conclusion <p>This retrospective study using real-world data showed that second-line PFS and PFS2 were longer in patients treated with prior IO–IO combination therapy than in those treated with IO–TKI combination therapy.</p>

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Impact of first-line dual immuno-oncology combination therapy versus immuno-oncology plus tyrosine kinase inhibitor on outcomes of second-line VEGFR-TKI in advanced RCC: a real-world multi-institutional analysis

  • 期刊论文

  • 发表日期：

    2025年9月1日

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  • Koichi Nishimura,
  • Hiroki ishihara,
  • Yuki Nemoto,
  • Shinsuke Mizoguchi,
  • Takayuki Nakayama,
  • Hironori Fukuda,
  • Kazuhiko Yoshida,
  • Hiroaki Shimmura,
  • Yasunobu Hashimoto,
  • Junpei Iizuka,
  • Tsunenori Kondo,
  • Toshio Takagi

摘要

Background

Data on the impact of first-line immune checkpoint inhibitor (ICI) combination therapy regimen on the outcomes of second-line tyrosine kinase inhibitor (TKI) treatment for advanced renal-cell carcinoma (RCC) remain limited.

Methods

We retrospectively evaluated data from 105 patients who discontinued first-line ICI combination therapy. Progression-free survival (PFS) after second-line TKI treatment and PFS2, defined as the sum of PFS during first-line and second-line therapies, were compared between patients who received dual ICI combination therapy (i.e., immunotherapy [IO]–IO) and those who received a combination of ICI and TKI (i.e., IO–TKI).

Result

Of the 105 patients, 66 (63%) and 39 (37%) were treated with first-line IO–IO and IO–TKI combination therapy, respectively. The conversion rate to second-line therapy was higher in the IO–IO treatment group than in the IO–TKI group (73 vs. 54%, p = 0.0489). Sixty-six patients received second-line TKI treatment, and second-line PFS was longer in the IO–IO treatment group than in the IO–TKI group (median: 12.1 vs. 6.3 months, p = 0.0048). Additionally, PFS2 was longer in the IO–IO treatment group than in the IO–TKI group (median: 19.7 vs. 15.4 months, p = 0.0416). After adjusting for other covariates, the first-line treatment regimen (i.e., IO–IO vs. IO–TKI) was identified as an independent factor for PFS2 (HR: 0.51, p = 0.0057).

Conclusion

This retrospective study using real-world data showed that second-line PFS and PFS2 were longer in patients treated with prior IO–IO combination therapy than in those treated with IO–TKI combination therapy.