Efficacy and safety of lenvatinib and pembrolizumab as first-line treatment for advanced renal cell carcinoma patients: real-world experience in Japan.

IF 2.4 3区 医学 Q3 ONCOLOGY International Journal of Clinical Oncology Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI:10.1007/s10147-024-02633-w
Takuto Hara, Kotaro Suzuki, Yasuyoshi Okamura, Koji Chiba, Ryo Sato, Yuto Matsushita, Keita Tamura, Gaku Ishikawa, Atsushi Otsuka, Hideaki Miyake
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Abstract

Background: Combined treatment with lenvatinib and pembrolizumab is currently regarded as one of the standard first-line therapies for advanced renal cell carcinoma (aRCC) patients. The objective of this study was to assess the efficacy and safety of this combined regimen in treatment-naïve Japanese aRCC patients.

Methods: This study included a total of 50 consecutive aRCC patients receiving combined lenvatinib plus pembrolizumab in routine clinical practice in Japan, and comprehensively analyzed clinical outcomes of this treatment.

Results: Of these 50, 7 (14.0%), 23 (46.0%) and 20 (40.0%) were classified into favorable, intermediate and poor risk groups, respectively, according to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) system. Responses to this combined therapy in the 50 patients were as follows: complete response, 7 (14.0%); partial response, 26 (52.0%); stable disease, 15 (30%) and progressive disease, 2 (4%); thus, the objective response rate (ORR) was 66%. ORRs in favorable, intermediate and poor risk groups were 57.1, 69.6 and 65.0%, respectively. During the observation period, disease progression and death occurred in 14 (28.0%) and 6 (12.0%) patients, respectively, and neither the median PFS nor OS was reached. Adverse events and those corresponding to grade ≥ 3 were observed in all (100%) and 33 (66.0%) patients, respectively.

Conclusions: To our knowledge, this is the first study focusing on real-world outcomes of lenvatinib and pembrolizumab for treatment-naïve aRCC patients, showing that the efficacy and safety of this combined regimen are similar to those noted in randomized clinical trial.

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来伐替尼和pembrolizumab作为晚期肾细胞癌患者一线治疗的有效性和安全性:日本的实际经验。
背景:来伐替尼和pembrolizumab联合治疗目前被视为晚期肾细胞癌(aRCC)患者的标准一线疗法之一。本研究的目的是评估这种联合疗法在治疗无效的日本 aRCC 患者中的疗效和安全性:本研究共纳入了50例连续接受来伐替尼加pembrolizumab联合治疗的日本常规临床实践中的aRCC患者,并全面分析了这种治疗方法的临床结果:根据国际转移性肾细胞癌数据库联盟(IMDC)的系统,这50名患者中分别有7人(14.0%)、23人(46.0%)和20人(40.0%)被划分为良好风险组、中等风险组和不良风险组。50 名患者对联合疗法的反应如下:完全反应 7 例(14.0%);部分反应 26 例(52.0%);病情稳定 15 例(30%);病情进展 2 例(4%);因此,客观反应率(ORR)为 66%。良好、中等和不良风险组的客观应答率分别为 57.1%、69.6% 和 65.0%。在观察期内,分别有14名(28.0%)和6名(12.0%)患者出现疾病进展和死亡,PFS和OS均未达到中位数。所有患者(100%)和33名患者(66.0%)分别出现了不良事件和≥3级的不良事件:据我们所知,这是第一项关注来伐替尼和pembrolizumab对治疗无效的aRCC患者实际疗效的研究,结果显示这种联合疗法的疗效和安全性与随机临床试验中的结果相似。
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来源期刊
CiteScore
6.80
自引率
3.00%
发文量
175
审稿时长
2 months
期刊介绍: The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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