Abstract
Background
Immune checkpoint inhibitor (ICI)-based combinations have become the first-line standard
of care in metastatic renal cell carcinoma (mRCC), but their activity on the primary
tumor is still one of the most debated issues.
Patients and Methods
The aim of our analysis was to evaluate the primary tumor's response to first-line
therapy with cabozantinib or nivolumab+ipilimumab, and its correlation with metastatic
response and with patient outcomes.
Results
Sixty-seven mRCC patients met the criteria for inclusion in the final analysis (30
treated with cabozantinib and 37 with nivolumab+ipilimumab). In the overall population,
the primary tumor control rate (PTCR) was 90.9%; no complete responses (CR) were achieved.
A significant correlation was found between the baseline size of the primary tumor's
longest diameter and its response according to RECIST v1.1 criteria at the time of
the second radiological assessment (rs = -0.351; P = .049). Moreover, a significant correlation between the type of primary tumor response
and the response of the metastases was observed in the overall population (rs = 0.50;
two-sided P < 0.001). There was also a significant correlation between primary tumor response
and 1-year survival rate (P = .002), even when adjusted for the IMDC prognostic group and type of therapy (HR = 8.70;
95%CI, 2.52-30.05; P = .001).
Conclusion
Extension of the primary tumor did not affect patient survival, while its response
was significantly related to the response on metastatic disease and survival. No significant
differences in terms of primary tumor shrinkage were identified between treatment
with nivolumab+ipilimumab or cabozantinib in this cohort.
Keywords
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Article Info
Publication History
Published online: June 08, 2022
Accepted:
June 5,
2022
Received in revised form:
May 23,
2022
Received:
July 5,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
