Real-world short-term outcomes and treatment regimen comparisons in patients with metastatic renal cell carcinoma treated with first-line immune combinations
Abstract Background Immune-combinations have recently become the standard first-line treatment for patients with metastatic renal cell carcinoma (mRCC). This study evaluated the applicability of the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk model in predicting out...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12885-025-13504-6 |
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| author | Masato Kikuta Sei Naito Takahiro Osawa Kazuyuki Numakura Takafumi Narisawa Yuki Takai Mayu Yagi Yuya Sekine Ojiro Tokairin Nobuo Shinohara Tomonori Habuchi Norihiko Tsuchiya |
| author_facet | Masato Kikuta Sei Naito Takahiro Osawa Kazuyuki Numakura Takafumi Narisawa Yuki Takai Mayu Yagi Yuya Sekine Ojiro Tokairin Nobuo Shinohara Tomonori Habuchi Norihiko Tsuchiya |
| author_sort | Masato Kikuta |
| collection | DOAJ |
| description | Abstract Background Immune-combinations have recently become the standard first-line treatment for patients with metastatic renal cell carcinoma (mRCC). This study evaluated the applicability of the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk model in predicting outcomes for patients treated with either immune-oncologic drug doublet (IO-IO) or immune-oncologic drug tyrosine kinase inhibitor combinations (IO-TKI). A secondary objective to compare the effectiveness of IO-IO versus IO-TKI within the IMDC risk groups over a short follow-up period. Methods A retrospective analysis was conducted on 172 patients with mRCC treated with first-line immunotherapy combinations. Progression free survival (PFS), time to treatment failure 2 (TTF2), and overall survival (OS) were compared between IMDC risk categories. Model fit was assessed using the c-index. The inverse probability of treatment weighting (IPTW) method was used to adjust and compare outcomes between IO-IO and IO-TKI, except for IMDC favorable risk patients due to the small number of IO-IO cases. Results The IMDC risk model demonstrated a c-index of 0.684 (OS) for entire cohort, 0.600 (PFS), 0.596 (TTF2), and 0.624 (OS) for IO-IO, and 0.667 (PFS), 0.702 (TTF2), and 0.751 (OS) for IO-TKI. In the IMDC intermediate and poor risk groups after IPTW adjustment, PFS (HR 0.72), TTF2 (HR 0.67), and OS (HR 0.74) did not significantly differ between IO-IO and IO-TKI. Specifically, in the IMDC intermediate risk group, PFS (HR 0.79), TTF2 (HR 0.69), and OS (HR 0.65) were longer in IO-TKI, though the differences were not statistically significant. In the IMDC poor risk group, PFS (HR 0.76), TTF2 (HR 0.77), and OS (HR 1.03) were comparable. Conclusions The impact of IMDC risk model on survival was modest in IO-IO, while remained statistically substantial in IO-TKI. Survival outcomes did not significantly differ between IO-IO and IO-TKI during the short follow-up period. |
| format | Article |
| id | doaj-art-93e83d9a23c9462f89ca3d5c3755fa7d |
| institution | Kabale University |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Cancer |
| spelling | doaj-art-93e83d9a23c9462f89ca3d5c3755fa7d2025-01-26T12:37:52ZengBMCBMC Cancer1471-24072025-01-0125111210.1186/s12885-025-13504-6Real-world short-term outcomes and treatment regimen comparisons in patients with metastatic renal cell carcinoma treated with first-line immune combinationsMasato Kikuta0Sei Naito1Takahiro Osawa2Kazuyuki Numakura3Takafumi Narisawa4Yuki Takai5Mayu Yagi6Yuya Sekine7Ojiro Tokairin8Nobuo Shinohara9Tomonori Habuchi10Norihiko Tsuchiya11Department of Urology, Yamagata University School of MedicineDepartment of Urology, Yamagata University School of MedicineDepartment of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido UniversityDepartment of Urology, Akita University Graduate School of MedicineDepartment of Urology, Yamagata University School of MedicineDepartment of Urology, Yamagata University School of MedicineDepartment of Urology, Yamagata University School of MedicineDepartment of Urology, Akita University Graduate School of MedicineDepartment of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido UniversityDepartment of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido UniversityDepartment of Urology, Akita University Graduate School of MedicineDepartment of Urology, Yamagata University School of MedicineAbstract Background Immune-combinations have recently become the standard first-line treatment for patients with metastatic renal cell carcinoma (mRCC). This study evaluated the applicability of the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk model in predicting outcomes for patients treated with either immune-oncologic drug doublet (IO-IO) or immune-oncologic drug tyrosine kinase inhibitor combinations (IO-TKI). A secondary objective to compare the effectiveness of IO-IO versus IO-TKI within the IMDC risk groups over a short follow-up period. Methods A retrospective analysis was conducted on 172 patients with mRCC treated with first-line immunotherapy combinations. Progression free survival (PFS), time to treatment failure 2 (TTF2), and overall survival (OS) were compared between IMDC risk categories. Model fit was assessed using the c-index. The inverse probability of treatment weighting (IPTW) method was used to adjust and compare outcomes between IO-IO and IO-TKI, except for IMDC favorable risk patients due to the small number of IO-IO cases. Results The IMDC risk model demonstrated a c-index of 0.684 (OS) for entire cohort, 0.600 (PFS), 0.596 (TTF2), and 0.624 (OS) for IO-IO, and 0.667 (PFS), 0.702 (TTF2), and 0.751 (OS) for IO-TKI. In the IMDC intermediate and poor risk groups after IPTW adjustment, PFS (HR 0.72), TTF2 (HR 0.67), and OS (HR 0.74) did not significantly differ between IO-IO and IO-TKI. Specifically, in the IMDC intermediate risk group, PFS (HR 0.79), TTF2 (HR 0.69), and OS (HR 0.65) were longer in IO-TKI, though the differences were not statistically significant. In the IMDC poor risk group, PFS (HR 0.76), TTF2 (HR 0.77), and OS (HR 1.03) were comparable. Conclusions The impact of IMDC risk model on survival was modest in IO-IO, while remained statistically substantial in IO-TKI. Survival outcomes did not significantly differ between IO-IO and IO-TKI during the short follow-up period.https://doi.org/10.1186/s12885-025-13504-6ComparisonImmunotherapyImmune-combinationsPrognosisRenal cell carcinoma; Tyrosine kinase inhibitor |
| spellingShingle | Masato Kikuta Sei Naito Takahiro Osawa Kazuyuki Numakura Takafumi Narisawa Yuki Takai Mayu Yagi Yuya Sekine Ojiro Tokairin Nobuo Shinohara Tomonori Habuchi Norihiko Tsuchiya Real-world short-term outcomes and treatment regimen comparisons in patients with metastatic renal cell carcinoma treated with first-line immune combinations BMC Cancer Comparison Immunotherapy Immune-combinations Prognosis Renal cell carcinoma; Tyrosine kinase inhibitor |
| title | Real-world short-term outcomes and treatment regimen comparisons in patients with metastatic renal cell carcinoma treated with first-line immune combinations |
| title_full | Real-world short-term outcomes and treatment regimen comparisons in patients with metastatic renal cell carcinoma treated with first-line immune combinations |
| title_fullStr | Real-world short-term outcomes and treatment regimen comparisons in patients with metastatic renal cell carcinoma treated with first-line immune combinations |
| title_full_unstemmed | Real-world short-term outcomes and treatment regimen comparisons in patients with metastatic renal cell carcinoma treated with first-line immune combinations |
| title_short | Real-world short-term outcomes and treatment regimen comparisons in patients with metastatic renal cell carcinoma treated with first-line immune combinations |
| title_sort | real world short term outcomes and treatment regimen comparisons in patients with metastatic renal cell carcinoma treated with first line immune combinations |
| topic | Comparison Immunotherapy Immune-combinations Prognosis Renal cell carcinoma; Tyrosine kinase inhibitor |
| url | https://doi.org/10.1186/s12885-025-13504-6 |
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