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Efficacy of nivolumab versus molecular‐targeted therapy as second‐line therapy for metastatic renal cell carcinoma: Real‐world data from two Japanese institutions
Author(s) -
Ishihara Hiroki,
Fukuda Hironori,
Takagi Toshio,
Kondo Tsunenori,
Tachibana Hidekazu,
Yoshida Kazuhiko,
Iizuka Junpei,
Kobayashi Hirohito,
Ishida Hideki,
Tanabe Kazunari
Publication year - 2021
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.14412
Subject(s) - medicine , nivolumab , targeted therapy , renal cell carcinoma , oncology , hazard ratio , progression free survival , multivariate analysis , overall survival , immunotherapy , cancer , confidence interval
Objectives To compare the efficacy of nivolumab with that of molecular‐targeted therapy as a second‐line therapy for metastatic renal cell carcinoma using real‐world data. Methods We retrospectively evaluated patients who received nivolumab or molecular‐targeted therapy after the failure of first‐line molecular‐targeted therapy between January 2008 and December 2019 at two Japanese institutions. Progression‐free survival and overall survival after the initiation of second‐line therapy were calculated using the Kaplan‐Meier method and compared using the log‐rank test. Objective response rate was assessed based on the Response Evaluation Criteria in Solid Tumors version 1.1. Results Among 159 patients, 43 (27%) and 116 (73%) patients received nivolumab and molecular‐targeted therapy as second‐line therapy, respectively. During follow up (median 11.1 months), 129 (81%) and 98 (62%) patients had disease progression and died, respectively. Progression‐free survival was comparable between the two treatments (median 5.06 vs 5.95 months, P = 0.881), whereas overall survival was significantly longer with nivolumab than with molecular‐targeted therapy (not reached vs 13.0 months, P = 0.0008). Multivariate analysis further showed that nivolumab therapy was an independent favorable factor for overall survival (hazard ratio 0.33, P = 0.0007). In 151 patients with eligible radiographic data, the objective response rate was significantly higher in nivolumab than in molecular‐targeted therapy ( n = 14/41 [34%] vs n = 20/110 [18%], P = 0.0485). Conclusions Real‐world data analysis suggests superior efficacy of nivolumab over molecular‐targeted therapy as second‐line therapy for metastatic renal cell carcinoma.