|
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 | Efficacy and safety of immune checkpoint inhibitors in elderly patients with metastatic renal cell carcinoma. |
| 掲載誌名 | 正式名：International urology and nephrology 略 称：Int Urol Nephrol ISSNコード：03011623/15732584 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 54(1),pp.47-54 |
| 著者・共著者 | NEMOTO Yuki†, ISHIHARA Hiroki*, NAKAMURA Kazutaka, TACHIBANA Hidekazu, FUKUDA Hironori, YOSHIDA Kazuhiko, KOBAYASHI Hirohito, IIZUKA Junpei, SHIMMURA Hiroaki, HASHIMOTO Yasunobu, TANABE Kazunari, KONDO Tsunenori, TAKAGI Toshio |
| 発行年月 | 2022/01 |
| 概要 | PURPOSE:To clarify the efficacy and safety profile of immune checkpoint inhibitors (ICIs) for elderly patients with metastatic renal cell carcinoma (mRCC).METHODS:We retrospectively evaluated 149 mRCC patients treated with nivolumab monotherapy as subsequent therapy (n = 89) and nivolumab plus ipilimumab as first-line therapy (n = 60) at 5 affiliated institutions. The patients were divided according to age: > 70 (elderly) vs. ≤ 70 years (young). Efficacy was analyzed by comparing progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and disease control rate (DCR) between elderly and young patients. Safety was assessed by comparing the incidence rates of immune-related adverse events (irAEs).RESULTS:In the nivolumab monotherapy group, 34/89 patients (38%) were classified as elderly. There was no significant difference in PFS (p = 0.607), OS (p = 0.383), ORR (p = 0.0699), or DCR (p = 0.881) between elderly and young patients. In the nivolumab plus ipilimumab group, 20/60 patients (33%) were classified as elderly. There was no significant difference in PFS (p = 0.995), OS (p = 0.714), ORR (p = 0.763), or DCR (p = 1.000) between the two groups. The incidence rate of irAEs was not significantly different in the nivolumab (any grade: p = 0.121; grade ≥ 3: p = 0.542) or in the nivolumab plus ipilimumab (any grade: p = 0.666; grade ≥ 3: p = 0.576) group; a higher rate of gastrointestinal irAEs was observed in elderly than in young patients (any grade 15% vs. 3%).CONCLUSIONS:The efficacy and safety of nivolumab monotherapy and nivolumab plus ipilimumab were comparable between elderly and young patients. Thus, chronological age alone should not be a contraindication in the use of ICIs for mRCC. |
| DOI | 10.1007/s11255-021-03042-y |
| PMID | 34704214 |