Copyright
©The Author(s) 2022.
World J Clin Oncol. Jan 24, 2022; 13(1): 28-38
Published online Jan 24, 2022. doi: 10.5306/wjco.v13.i1.28
Published online Jan 24, 2022. doi: 10.5306/wjco.v13.i1.28
Table 1 Poor prognostic factor
Poor prognostic factor | MSKCC | IMDC |
Time from diagnosis to treatment | < 12 mo | < 12 mo |
Hemoglobin | < lower limit of normal | < lower limit of normal |
Corrected serum calcium | > 10 mg/dl (2.5 mmol/L) | > upper limit of normal |
Karnofsky performance score | < 80% | < 80% |
Neutrophil count | / | > upper limit of normal |
Platelet count | / | > upper limit of normal |
Lactate dehydrogenase | > 1.5 x upper limit of normal | / |
Good risk | 0 risk factor | 0 risk factor |
Intermediate risk | 1 or 2 risk factors | 1 or 2 risk factors |
Poor risk | 3, 4 or 5 risk factors | 3, 4, 5 or 6 risk factors |
Table 2 Results of phase 3 studies in first line treatment of patients with metastatic clear cell renal cell cancer
Drug/Study | No. of patients | Follow-up (mo) | PFS (mo) | OS (mo) | ORR, % | Ref. |
Nivolumab/Ipilimumab vs Sunitinib (Checkmate 214) | 1096 | 48 | ITT 12.2 vs 12.3; HR 0.89; I/P risk 11.2 vs 8.3; HR 0.74 | ITT NR vs 38.4; HR 0.69; I/P risk 48.1 vs 26.6; HR 0.65; F risk; HR 0.93 | ITT 39.1 vs 32.4; I/P risk 41.9 vs 26.8; F risk 29.6 vs 51.6 | [24] |
Pembrolizumab/Axitinib vs Sunitinib (Keynote 426) | 861 | 27 | ITT 15.4 vs 11.1; HR 0.71; P < 0.0001 | ITT NR vs 35.7; HR 0.68; P = 0.0003 | ITT 60 vs 40 | [39] |
Avelumab/Axitinib vs Sunitinib (Javelin 101) | 560 | 13 | ITT 13.3 vs 8; HR 0.69; P < 0.0001; PD-L1 + 13.8 vs 7; HR 0.62; P < 0.0001 | ITT NR; HR 0.80; P = 0.0392; PD-L1 + NR; HR 0.83; P = 0.1301 | ITT 52.5 vs 27.3; PD-L1 + 55.9 vs 27.3 | [44] |
Nivolumab/Cabozantinib vs Sunitinib (Checkmate 9ER) | 651 | 18.1 | ITT 16.6 vs 8.3; HR 0.51; P < 0.0001 | ITT NR vs NR; HR 0.60; P = 0.0010 | ITT 55.7 vs 27.1 | [45] |
Pembrolizumab/Lenvatinib vs Everolimus/Lenvatinib vs Sunitinib (Clear/Keynote 581) | 1069 | 26.6 | ITT Pembro/lenva vs sunitinib 23.9 vs 9.2; HR 0.39; P < 0.000; Everolimus/lenva vs sunitinib; 14.7 vs 9.2; HR 0.65; P < 0.0001 | ITT Pembro/lenva vs sunitinib NR vs NR; HR 0.66; P = 0.005; Evero/lenva vs sunitinib NR vs NR; HR 1.15; P = 0.30 | ITT Pembro/lenva vs Evero/lenva vs sunitinib; 71% vs 53.5% vs 36.1% | [41] |
Table 3 Results of checkpoint inhibitors in treatment of patients with metastatic clear cell renal cell cancer
Drug/Study | Phase | Indication | Follow-up | Results | Ref. |
Pembrolizumab (Keynote 427) | II | mnccRR | 11 | ITT ORR 24.8%; ORR Papillary vs phromophobe vs unclasified 25.4% vs 9.5% vs 34.6%; 12 mo PFS 22.8%; 12 mo OS 72% | [50] |
Nivolumab (Checkmate 374) | IIIb/IV | mnccRR | 11 | ITT; OS 16,3 mo; PFS 2,2 mo; ORR 13,6% | [51] |
Atezolizumab/Cabozantinib (Cosmic 021) | Ib | mnccRR | 9,2 | ITT ORR 33% | [52] |
Durvalumab/Savolitinib (Calypso) | Ib/II | mnccRCC-papillaryuntreated or previously treated | 8,9 | ITT; ORR 27%; PFS 3,3 mo; Untreated ORR 29%; PFS 12,2 | [53] |
- Citation: Popovic M, Matovina-Brko G, Jovic M, Popovic LS. Immunotherapy: A new standard in the treatment of metastatic clear cell renal cell carcinoma. World J Clin Oncol 2022; 13(1): 28-38
- URL: https://www.wjgnet.com/2218-4333/full/v13/i1/28.htm
- DOI: https://dx.doi.org/10.5306/wjco.v13.i1.28