Optimal treatment duration in metastatic renal cell carcinoma patients responding to immune checkpoint inhibitors: should we treat beyond two years?
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| Titel: | Optimal treatment duration in metastatic renal cell carcinoma patients responding to immune checkpoint inhibitors: should we treat beyond two years? |
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| Autoren: | Decruyenaere, Alexander, Gennigens, Christine, Sylvie, Rottey, Annouschka, Laenen, Seront, Emmanuel, Everaert, Els, Debruyne, Philip R, Van Den Bulck, Heidi, Bastin, Julie, Annelies, Verbiest, Vulsteke, Christof, Schatteman, Peter, Luyten, Daisy, Aspeslagh, Sandrine, Martinez-Chanza, Nieves, De Bock, Marlies, Meyskens, Thomas, Verheezen, Jolanda, Brouwers, Barbara, Beuselinck, Benoit |
| Weitere Verfasser: | Decruyenaere, Alexander, Gennigens, Christine, Rottey, Sylvie, LAENEN, Annouschka, Seront, Emmanuel, Everaert, Els, Debruyne, Philip R., van den Bulck, Heidi, Bastin, Julie, Verbiest, Annelies, Vulsteke, Christof, Schatteman, Peter, Luyten , Daisy, Aspeslagh, Sandrine, Martinez-Chanza, Nieves, De Bock, Marlies, Meyskens, Thomas, Verheezen, Jolanda, Brouwers , Barbara, Beuselinck, Benoit |
| Quelle: | Acta Oncologica, Vol 64 (2025) Acta oncologica ACTA ONCOLOGICA |
| Verlagsinformationen: | MJS Publishing, Medical Journals Sweden AB, 2025. |
| Publikationsjahr: | 2025 |
| Schlagwörter: | Male, Immune Checkpoint Inhibitors/administration & dosage, Radiology, Nuclear Medicine and Imaging, Time Factors, Oncologie, THERAPY, Carcinoma, Renal Cell/secondary, immune checkpoint inhibitors, Antineoplastic Combined Chemotherapy Protocols, Medicine and Health Sciences, Ipilimumab/administration & dosage, Human health sciences, Kidney Neoplasms/mortality, Immune Checkpoint Inhibitors, RC254-282, Aged, 80 and over, OUTCOMES, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Carcinoma, Renal Cell/pathology, Hematology, Antineoplastic Combined Chemotherapy Protocols/administration & dosage, Middle Aged, Kidney Neoplasms, Progression-Free Survival, Renal cell carcinoma, Nivolumab/administration & dosage, treatment discontinuation, Carcinoma, Renal Cell/mortality, Kidney Neoplasms/drug therapy, Nivolumab, optimal treatment duration, Oncology, Female, Life Sciences & Biomedicine, Adult, DISCONTINUATION, Sciences de la santé humaine, Kidney Neoplasms/pathology, Immune Checkpoint Inhibitors/adverse effects, 3211 Oncology and carcinogenesis, Humans, 1112 Oncology and Carcinogenesis, Oncology & Carcinogenesis, Carcinoma, Renal Cell, Retrospective Studies, Aged, Science & Technology, Duration of Therapy, Immune Checkpoint Inhibitors/therapeutic use, Ipilimumab, MELANOMA PATIENTS, Carcinoma, Renal Cell/drug therapy, Human medicine, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Follow-Up Studies |
| Beschreibung: | Background and purpose: Optimal treatment duration is unknown in metastatic renal cell carcinoma (mRCC) responding to immune checkpoint inhibitors (ICPIs). Prolonged treatment can lead to late toxicity, burden for day clinics and financial impact. Patients and methods: This multicenter retrospective study included mRCC patients responding to ipilimumab/nivolumab in first-line or nivolumab in later lines, who were treated for at least 21 months and did not stop for toxicity. Progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS) were modeled non- and semi-parametrically. The effect of elective ICPI discontinuation (i.e. treatment interruption at the clinician’s discretion) between 21 and 25 months on PFS was assessed by a causal inference approach using artificial censoring along with inverse probability of censoring weighting. Results: Ninety-five patients were included with a median follow-up of 62.1 (95% confidence interval [CI]: 57.3–67.5) months. Fifty-four received ipilimumab/nivolumab, whereas 41 patients received nivolumab, for a median treatment duration of 33.8 (95% CI: 28.5–39.6) months. Fifty-seven patients discontinued ICPIs electively. Three-year PFS after discontinuation was 57.1% (95% CI: 34.3–95.1), 3-year OS 67.5% (95% CI: 37.0–100.0), and 3-year CSS 90.0% (95% CI: 73.2–100.0). Fifteen (15.8%) patients discontinued ICPIs between 21 and 25 months. Compared to 80 patients who were treated longer, they had more often a metachronous metastatic pattern (p = 0.048) and a complete response (p = 0.045). Elective ICPI stop between 21 and 25 months did not significantly impact the hazard for progression/death (adjusted HR 1.08, 95% CI: 0.64–1.84, p = 0.766). Interpretation: Among mRCC patients responding to ICPI, elective therapy discontinuation approximately 24 months after initiation does not appear to compromise outcomes compared to continuing therapy. |
| Publikationsart: | Article |
| Dateibeschreibung: | application/pdf |
| ISSN: | 1651-226X |
| DOI: | 10.2340/1651-226x.2025.43876 |
| Zugangs-URL: | https://doaj.org/article/f0b66be9934249d38e034df42f696b62 https://hdl.handle.net/2268/335276 https://doi.org/10.2340/1651-226X.2025.43876 https://repository.uantwerpen.be/docstore/d:irua:30312 https://hdl.handle.net/10067/2161490151162165141 http://hdl.handle.net/1942/46632 http://hdl.handle.net/1854/LU-01K3QQRTE94KZYP1CX1X0WZ5CD https://biblio.ugent.be/publication/01K3QQRTE94KZYP1CX1X0WZ5CD/file/01K42SV66F3YD38FGWT899GJ86 https://biblio.ugent.be/publication/01K3QQRTE94KZYP1CX1X0WZ5CD http://doi.org/10.2340/1651-226x.2025.43876 |
| Rights: | CC BY |
| Dokumentencode: | edsair.doi.dedup.....4662ebbdfe4f888a9e80a32b18f8723e |
| Datenbank: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | Background and purpose: Optimal treatment duration is unknown in metastatic renal cell carcinoma (mRCC) responding to immune checkpoint inhibitors (ICPIs). Prolonged treatment can lead to late toxicity, burden for day clinics and financial impact. Patients and methods: This multicenter retrospective study included mRCC patients responding to ipilimumab/nivolumab in first-line or nivolumab in later lines, who were treated for at least 21 months and did not stop for toxicity. Progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS) were modeled non- and semi-parametrically. The effect of elective ICPI discontinuation (i.e. treatment interruption at the clinician’s discretion) between 21 and 25 months on PFS was assessed by a causal inference approach using artificial censoring along with inverse probability of censoring weighting. Results: Ninety-five patients were included with a median follow-up of 62.1 (95% confidence interval [CI]: 57.3–67.5) months. Fifty-four received ipilimumab/nivolumab, whereas 41 patients received nivolumab, for a median treatment duration of 33.8 (95% CI: 28.5–39.6) months. Fifty-seven patients discontinued ICPIs electively. Three-year PFS after discontinuation was 57.1% (95% CI: 34.3–95.1), 3-year OS 67.5% (95% CI: 37.0–100.0), and 3-year CSS 90.0% (95% CI: 73.2–100.0). Fifteen (15.8%) patients discontinued ICPIs between 21 and 25 months. Compared to 80 patients who were treated longer, they had more often a metachronous metastatic pattern (p = 0.048) and a complete response (p = 0.045). Elective ICPI stop between 21 and 25 months did not significantly impact the hazard for progression/death (adjusted HR 1.08, 95% CI: 0.64–1.84, p = 0.766). Interpretation: Among mRCC patients responding to ICPI, elective therapy discontinuation approximately 24 months after initiation does not appear to compromise outcomes compared to continuing therapy. |
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| ISSN: | 1651226X |
| DOI: | 10.2340/1651-226x.2025.43876 |