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.
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).
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).
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.
International urology and nephrology. 2025 Sep 01 [Epub ahead of print]
Koichi Nishimura, Hiroki Ishihara, Yuki Nemoto, Shinsuke Mizoguchi, Takayuki Nakayama, Hironori Fukuda, Kazuhiko Yoshida, Hiroaki Shimmura, Yasunobu Hashimoto, Junpei Iizuka, Tsunenori Kondo, Toshio Takagi
Department of Urology, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan., Department of Urology, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama, Japan. ., Department of Urology, Jyoban Hospital, Fukushima, Japan., Department of Urology, Saiseikai Kazo Hospital, Saitama, Japan., Department of Urology, Tokyo Women's Medical University, Tokyo, Japan., Department of Urology, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama, Japan.