Stereotactic body radiotherapy in combination with non-frontline PD-1 inhibitors and targeted agents in metastatic renal cell carcinoma

Abstract Background Radiotherapy may work synergistically with immunotherapy and targeted agents. We aimed to assess the safety and outcomes of stereotactic body radiotherapy (SBRT) plus non-first-line programmed death-1 (PD-1) inhibitors and targeted agents (TA) in metastatic renal cell carcinoma (...

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Autores principales:	Yang Liu, Zhiling Zhang, Ruiqi Liu, Wensu Wei, Zitong Zhang, Lixin Mai, Shengjie Guo, Hui Han, Fangjian Zhou, Liru He, Pei Dong
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Renal cell carcinoma Metastasis Anti-PD-1 therapy Targeted therapy Stereotactic body radiation therapy Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/3e0f90f743e142d0bc4168cf48440244
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spelling	oai:doaj.org-article:3e0f90f743e142d0bc4168cf484402442021-11-08T10:45:03ZStereotactic body radiotherapy in combination with non-frontline PD-1 inhibitors and targeted agents in metastatic renal cell carcinoma10.1186/s13014-021-01937-91748-717Xhttps://doaj.org/article/3e0f90f743e142d0bc4168cf484402442021-11-01T00:00:00Zhttps://doi.org/10.1186/s13014-021-01937-9https://doaj.org/toc/1748-717XAbstract Background Radiotherapy may work synergistically with immunotherapy and targeted agents. We aimed to assess the safety and outcomes of stereotactic body radiotherapy (SBRT) plus non-first-line programmed death-1 (PD-1) inhibitors and targeted agents (TA) in metastatic renal cell carcinoma (mRCC). Methods We retrospectively reviewed 74 patients treated with non-first-line PD-1 inhibitors plus TA in non-first-line setting. Survival outcomes were calculated from the anti-PD-1 treatment using the Kaplan–Meier method. Univariate and multivariate analyses were performed by Cox proportional hazards models. Results Thirty-two (43.2%) patients received anti-PD-1/TA therapy alone (anti-PD-1/TA alone group), and 42 (56.8%) received SBRT in addition (anti-PD-1/TA + SBRT group). The median duration of first-line therapy was 8.6 months. Patients in the anti-PD-1/TA + SBRT group had significantly longer overall survival (OS) (38.5 vs 15.4 months; P = 0.022). On multivariate analysis, oligometastasis, ECOG performance status 0–1, anti-PD-1/TA + SBRT, and duration of first-line therapy ≥ 8.6 months were predictors for OS. The addition of SBRT was associated with improved OS in patients with clear-cell type (HR 0.19; 95% CI 0.07–0.55; P = 0.002) and duration of first-line therapy ≥ 8.6 months (HR 0.22; 95% CI 0.06–0.88; P = 0.032). Grade ≥ 3 toxicities occurred in 23 patients (54.8%) in the anti-PD-1/TA + SBRT group, and in 21 patients (65.6%) in the anti-PD-1/TA alone group. Conclusions Incorporating SBRT into anti-PD-1/TA therapy is safe and tolerable. Further investigation is needed, particularly in patients with clear-cell histology and a longer duration of response to first-line antiangiogenic therapy.Yang LiuZhiling ZhangRuiqi LiuWensu WeiZitong ZhangLixin MaiShengjie GuoHui HanFangjian ZhouLiru HePei DongBMCarticleRenal cell carcinomaMetastasisAnti-PD-1 therapyTargeted therapyStereotactic body radiation therapyMedical physics. Medical radiology. Nuclear medicineR895-920Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENRadiation Oncology, Vol 16, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Renal cell carcinoma Metastasis Anti-PD-1 therapy Targeted therapy Stereotactic body radiation therapy Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Renal cell carcinoma Metastasis Anti-PD-1 therapy Targeted therapy Stereotactic body radiation therapy Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Yang Liu Zhiling Zhang Ruiqi Liu Wensu Wei Zitong Zhang Lixin Mai Shengjie Guo Hui Han Fangjian Zhou Liru He Pei Dong Stereotactic body radiotherapy in combination with non-frontline PD-1 inhibitors and targeted agents in metastatic renal cell carcinoma
description	Abstract Background Radiotherapy may work synergistically with immunotherapy and targeted agents. We aimed to assess the safety and outcomes of stereotactic body radiotherapy (SBRT) plus non-first-line programmed death-1 (PD-1) inhibitors and targeted agents (TA) in metastatic renal cell carcinoma (mRCC). Methods We retrospectively reviewed 74 patients treated with non-first-line PD-1 inhibitors plus TA in non-first-line setting. Survival outcomes were calculated from the anti-PD-1 treatment using the Kaplan–Meier method. Univariate and multivariate analyses were performed by Cox proportional hazards models. Results Thirty-two (43.2%) patients received anti-PD-1/TA therapy alone (anti-PD-1/TA alone group), and 42 (56.8%) received SBRT in addition (anti-PD-1/TA + SBRT group). The median duration of first-line therapy was 8.6 months. Patients in the anti-PD-1/TA + SBRT group had significantly longer overall survival (OS) (38.5 vs 15.4 months; P = 0.022). On multivariate analysis, oligometastasis, ECOG performance status 0–1, anti-PD-1/TA + SBRT, and duration of first-line therapy ≥ 8.6 months were predictors for OS. The addition of SBRT was associated with improved OS in patients with clear-cell type (HR 0.19; 95% CI 0.07–0.55; P = 0.002) and duration of first-line therapy ≥ 8.6 months (HR 0.22; 95% CI 0.06–0.88; P = 0.032). Grade ≥ 3 toxicities occurred in 23 patients (54.8%) in the anti-PD-1/TA + SBRT group, and in 21 patients (65.6%) in the anti-PD-1/TA alone group. Conclusions Incorporating SBRT into anti-PD-1/TA therapy is safe and tolerable. Further investigation is needed, particularly in patients with clear-cell histology and a longer duration of response to first-line antiangiogenic therapy.
format	article
author	Yang Liu Zhiling Zhang Ruiqi Liu Wensu Wei Zitong Zhang Lixin Mai Shengjie Guo Hui Han Fangjian Zhou Liru He Pei Dong
author_facet	Yang Liu Zhiling Zhang Ruiqi Liu Wensu Wei Zitong Zhang Lixin Mai Shengjie Guo Hui Han Fangjian Zhou Liru He Pei Dong
author_sort	Yang Liu
title	Stereotactic body radiotherapy in combination with non-frontline PD-1 inhibitors and targeted agents in metastatic renal cell carcinoma
title_short	Stereotactic body radiotherapy in combination with non-frontline PD-1 inhibitors and targeted agents in metastatic renal cell carcinoma
title_full	Stereotactic body radiotherapy in combination with non-frontline PD-1 inhibitors and targeted agents in metastatic renal cell carcinoma
title_fullStr	Stereotactic body radiotherapy in combination with non-frontline PD-1 inhibitors and targeted agents in metastatic renal cell carcinoma
title_full_unstemmed	Stereotactic body radiotherapy in combination with non-frontline PD-1 inhibitors and targeted agents in metastatic renal cell carcinoma
title_sort	stereotactic body radiotherapy in combination with non-frontline pd-1 inhibitors and targeted agents in metastatic renal cell carcinoma
publisher	BMC
publishDate	2021
url	https://doaj.org/article/3e0f90f743e142d0bc4168cf48440244
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Stereotactic body radiotherapy in combination with non-frontline PD-1 inhibitors and targeted agents in metastatic renal cell carcinoma

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