PMID- 37130778
OWN - NLM
STAT- MEDLINE
DCOM- 20230918
LR  - 20230925
IS  - 1442-2042 (Electronic)
IS  - 0919-8172 (Linking)
VI  - 30
IP  - 9
DP  - 2023 Sep
TI  - Impact of cytoreductive nephrectomy prior to combination therapy of ipilimumab 
      plus nivolumab in metastatic renal cell carcinoma.
PG  - 746-752
LID - 10.1111/iju.15193 [doi]
AB  - OBJECTIVES: The efficacy of cytoreductive nephrectomy (CN) for metastatic renal 
      cell carcinoma (mRCC) treated with immune checkpoint inhibitors (ICIs) has been 
      suggested in the real-world setting. We retrospectively examined the efficacy of 
      CN prior to nivolumab plus ipilimumab systemic therapy for synchronous mRCC. 
      METHODS: Synchronous mRCC patients who received nivolumab plus ipilimumab at Kobe 
      University Hospital or five affiliated hospitals between October 2018 and 
      December 2021 were included in this study. We compared the outcomes of objective 
      response rate (ORR), progression-free survival (PFS), overall survival (OS), and 
      adverse events (AEs) between patients with CN prior to systemic therapy and 
      without CN. In addition, patients were 1:1 matched by propensity scores 
      accounting for factors associated with treatment assignment. RESULTS: Twenty-one 
      patients received CN prior to nivolumab plus ipilimumab (Prior CN) and 33 
      received nivolumab plus ipilimumab alone (Without CN). PFS of the Prior CN group 
      was 10.8 months (95%CI 5.5-NR) and 3.4 months (95%CI 2.0-5.9) for the Without CN 
      group (p = 0.0158). OS of Prior CN was 38.4 months (95%CI NR-NR) and 12.6 months 
      (95%CI 4.2-30.8) for Without CN (p = 0.0024). Univariate and multivariate 
      analyses identified prior CN as a significant prognostic indicator for PFS and 
      OS. Moreover, propensity score matching analysis showed significant improvements 
      in PFS and OS in Prior CN. CONCLUSIONS: Patients who underwent CN prior to 
      nivolumab plus ipilimumab systemic therapy for synchronous mRCC had a better 
      prognosis than patients treated with nivolumab plus ipilimumab alone. These 
      results suggest the efficacy of prior CN for synchronous mRCC with ICI 
      combination therapy.
CI  - (c) 2023 The Japanese Urological Association.
FAU - Hara, Takuto
AU  - Hara T
AUID- ORCID: 0000-0003-4524-2815
AD  - Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
AD  - Department of Urology, University of Occupational and Environmental Health, 
      Kitakyushu, Japan.
FAU - Furukawa, Junya
AU  - Furukawa J
AD  - Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
AD  - Department of Urology, University of Occupational and Environmental Health, 
      Kitakyushu, Japan.
FAU - Shiraishi, Yusuke
AU  - Shiraishi Y
AUID- ORCID: 0000-0001-9166-3448
AD  - Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
AD  - Department of Urology, University of Occupational and Environmental Health, 
      Kitakyushu, Japan.
FAU - Okamura, Yasuyoshi
AU  - Okamura Y
AD  - Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
AD  - Department of Urology, University of Occupational and Environmental Health, 
      Kitakyushu, Japan.
FAU - Bando, Yukari
AU  - Bando Y
AUID- ORCID: 0000-0001-7736-1216
AD  - Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
AD  - Department of Urology, University of Occupational and Environmental Health, 
      Kitakyushu, Japan.
FAU - Terakawa, Tomoaki
AU  - Terakawa T
AUID- ORCID: 0000-0002-4447-6516
AD  - Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
AD  - Department of Urology, University of Occupational and Environmental Health, 
      Kitakyushu, Japan.
FAU - Harada, Kenichi
AU  - Harada K
AUID- ORCID: 0000-0002-0242-9674
AD  - Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
AD  - Department of Urology, University of Occupational and Environmental Health, 
      Kitakyushu, Japan.
FAU - Nakano, Yuzo
AU  - Nakano Y
AD  - Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
AD  - Department of Urology, University of Occupational and Environmental Health, 
      Kitakyushu, Japan.
FAU - Fujisawa, Masato
AU  - Fujisawa M
AD  - Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
AD  - Department of Urology, University of Occupational and Environmental Health, 
      Kitakyushu, Japan.
LA  - eng
PT  - Journal Article
DEP - 20230502
PL  - Australia
TA  - Int J Urol
JT  - International journal of urology : official journal of the Japanese Urological 
      Association
JID - 9440237
RN  - 31YO63LBSN (Nivolumab)
RN  - 0 (Ipilimumab)
SB  - IM
CIN - Int J Urol. 2023 Sep;30(9):752-753. PMID: 37218357
MH  - Humans
MH  - *Carcinoma, Renal Cell/drug therapy/surgery
MH  - Nivolumab/adverse effects
MH  - Ipilimumab/adverse effects
MH  - *Kidney Neoplasms/drug therapy/surgery
MH  - Cytoreduction Surgical Procedures/adverse effects/methods
MH  - Retrospective Studies
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects
MH  - Nephrectomy/methods
OTO - NOTNLM
OT  - cytoreductive nephrectomy
OT  - immune checkpoint inhibitors
OT  - metastatic renal cell carcinoma
EDAT- 2023/05/03 00:41
MHDA- 2023/09/18 12:43
CRDT- 2023/05/02 21:53
PHST- 2022/10/12 00:00 [received]
PHST- 2023/04/11 00:00 [accepted]
PHST- 2023/09/18 12:43 [medline]
PHST- 2023/05/03 00:41 [pubmed]
PHST- 2023/05/02 21:53 [entrez]
AID - 10.1111/iju.15193 [doi]
PST - ppublish
SO  - Int J Urol. 2023 Sep;30(9):746-752. doi: 10.1111/iju.15193. Epub 2023 May 2.