卡波扎尼布
医学
肾细胞癌
危险系数
不利影响
内科学
肿瘤科
无容量
中止
易普利姆玛
无进展生存期
肾癌
泌尿科
癌症
免疫疗法
总体生存率
置信区间
作者
Hiroki Ishihara,Yasuhiro Nemoto,Hidekazu Tachibana,Hironori Fukuda,Kazuhiko Yoshida,Hirohito Kobayashi,Junpei Iizuka,Yuichi Hashimoto,Tsunenori Kondo,Toshio Takagi
出处
期刊:Japanese Journal of Clinical Oncology
[Oxford University Press]
日期:2023-07-29
卷期号:53 (10): 977-983
摘要
Abstract Background Real-world data of cabozantinib after failure of immune checkpoint inhibitors for advanced renal cell carcinoma in Japanese population are limited. Additionally, prognostic factors of cabozantinib in this setting are still unknown. Methods We retrospectively evaluated data of 56 patients treated with cabozantinib subsequent to failed immune checkpoint inhibitors at four institutions. Regarding the efficacy profile, progression-free survival, overall survival and objective response rate were assessed. In terms of the safety profile, rate of adverse events, dose reduction and treatment interruption were assessed. Furthermore, risk factors of progression-free survival were analyzed. Results Twenty-nine patients (52%) were treated with cabozantinib as second-line therapy. Most frequent prior immune checkpoint inhibitor treatment was nivolumab plus ipilimumab combination therapy as first-line therapy (n = 30, 54%). Median progression-free survival and overall survival were 9.76 and 25.5 months, respectively, and objective response rate was 34%. All patients experienced at least one adverse event, and grade ≥ 3 adverse events were observed in 31 patients (55%). Forty-four (79%) and 31 (55%) patients needed dose reduction and treatment interruption, respectively. Multivariate analysis showed that reduced initial dose (i.e. <60 mg) (hazard ratio: 2.50, P = 0.0355) and presence of lymph node metastasis (hazard ratio: 2.50, P = 0.0172) were independent factors of shorter progression-free survival. Conclusion Cabozantinib in Japanese patients with advanced renal cell carcinoma who failed immune checkpoint inhibitors was efficacious and had a manageable safety profile. These results appear to be similar to those of previous clinical trials.
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