コバヤシ　ヒロヒト   Kobayashi Hirohito   小林　博人    所属   医学部 医学科（附属足立医療センター）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Assessing improvements in metastatic renal cell carcinoma systemic treatments from the pre-cytokine to the immune checkpoint inhibitor eras: a retrospective analysis of real-world data.
掲載誌名	正式名：Japanese journal of clinical oncology 略　 称：Jpn J Clin Oncol ISSNコード：03682811/14653621
掲載区分	国外
巻・号・頁	51(5),pp.793-801
著者・共著者	ISHIHARA Hiroki†, TAKAGI Toshio, KONDO Tsunenori*, FUKUDA Hironori, TACHIBANA Hidekazu, YOSHIDA Kazuhiko, IIZUKA Junpei, KOBAYASHI Hirohito, OKUMI Masayoshi, ISHIDA Hideki, TANABE Kazunari
発行年月	2021/05
概要	OBJECTIVE:Studies assessing outcome improvements over a long period according to systemic therapy strategies for metastatic renal cell carcinoma using real-world data, including the results of the recent era of immune checkpoint inhibitors, are limited. Herein, we retrospectively evaluated patients who were diagnosed with metastatic renal cell carcinoma over a 40-year span.METHODS:Patients were classified into four groups based on when their metastases were diagnosed as follows: (i) the pre-cytokine era (1980-1986), (ii) the cytokine era (1987-2007), (iii) the molecular-targeted therapy (mTT) era (2008 to August 2016) and (iv) the immune checkpoint inhibitor era (September 2016 to 2018). The immune checkpoint inhibitor era consisted of second- or later-line nivolumab. Overall survival from the diagnoses of metastases was evaluated.RESULTS:In total, 576 patients were evaluated, including 22 (3.82%), 231 (40.1%), 253 (43.9%) and 70 (12.2%) patients from the pre-cytokine, cytokine, molecular-targeted therapy and immune checkpoint inhibitor eras, respectively. The overall survival significantly improved with each successive era (median: 13.1 vs. 24.5 vs. 44.4 months vs. not reached in pre-cytokine vs. cytokine vs. molecular-targeted therapy vs. immune checkpoint inhibitor eras, P < 0.0001). The implementation of molecular-targeted therapy improved overall survival compared with that of cytokine (cytokine vs. molecular-targeted therapy eras, P < 0.0001). Multivariate analysis demonstrated that the era was an independent factor for overall survival (P < 0.0001), together with histopathological type; metastasis status (i.e. synchronous or metachronous); systemic therapy status (i.e. absence or presence) and bone, liver or lymph node metastasis status (all, P < 0.05).CONCLUSION:This retrospective study of real-world data indicated that metastatic renal cell carcinoma outcomes improved with successive systemic therapy paradigms.
DOI	10.1093/jjco/hyaa232
PMID	33324983