ASCO GU 2021: What is the effectiveness of immunotherapy in the first line of metastatic renal cell carcinoma?

In 2018, Navuliyu monoantitor and episodhan was approved by the FDA for first-line treatment in patients with advanced renal cell carcinoma, and in 2019, the FDA approved Axitinib as a first-line treatment for patients with advanced renal cell carcinoma (RCC).
now, Nivolumab plus a combination of ilimumab and immunotherapy/vascular endodertic growth factor (VEGF) inhibitors has become a first-line treatment option for metastatic renal cell carcinoma (mRCC).
However, in the evolving therapeutic environment of mrCC, there is limited research on the positive contrast between these strategies: at the 2021 American Society of Clinical Oncology (ASCO) Urology (GU) Cancer Symposium, Dr. Chun Gan and colleagues presented the results of the treatment of the first-line immuno-oncology combination therapy in MRCC from the International Association for the Transfer of RCC Database (IMDC) database.
in the IMDC data set, patients treated with a combination of first-line immunotherapy/VEGF inhibitors (pim monoantiga sicinib, avelumab plus axithinib and nivolumab gabodinib) were compared with patients treated with nivolumab gabilimumab.
of interest were the overall remission rate, duration of treatment, next treatment time and overall survival rate.
a pre-planned subgroup analysis of IMDC medium/low risk populations and adjusted the risk ratio for IMDC risk factors.
723 patients included in the analysis, 571 patients who received nivolumab plus ipilimumab and 152 patients who received immunotherapy/VEGF inhibitor combinations.
in the nivolumab combined with immunotherapy/VEGF inhibitors, the proportion of patients with IMDC was favorable, with moderate and low-risk diseases at 9% to 33%, 58% to 53% and 33% to 14%, respectively.
in the medium/low risk group, the objective remission rate (37% to 59%) and the medium duration of treatment (4.6 to 15.0 months) were lower and shorter than in the immunotherapy/VEGF inhibitor combination: however, the next treatment between these groups was medium There was no difference in bit time and total lifetime: the death risk ratio of death adjustment in the COMBINATION of Inova monoantigen monoantigen and immunotherapy/VEGF inhibitors was 0.92 (95% confidence interval (CI) 0.61-1.40, p s 0.71).
the presence or effects of IMDC risk groups and sarcoma-like histology, brain, liver, or bone metastasis were independent of the total lifetime differences between these treatments (all p.gt; 0.2).
patients with dose delays due to immuno-related adverse events or steroid use (defined as pernisone equivalent/day/ 40 mg per day) had a longer mesothesis with the next treatment (21.6 vs. 9.5 months, p s 0.02) and overall survival rate (compared to patients who did not delay medication or use steroids, although the treatment time was similar (7.6 vs. 8.9 months, p s 0.77), was not reported .NR? vs. 44.4 months, p s 0.01). Dr.
Gan provided the following concluding statement for the presentation: Although the immunotherapy/VEGF inhibitor combination has a longer duration of treatment and a higher objective response rate, there is no difference between the total survival rate and the next treatment time between the nivolumab plus ipilimumab combination and the immunotherapy/VEGF inhibitor combination in the IMDC moderate/low-risk population.
the combination of severe immuno-related adverse events and improvements in total survival and next treatment time related to nivolumab plus monoantitherapy and immunotherapy/VEGF inhibitors are reasonable first-line strategies