This study aimed to evaluate the outcomes of patients with advanced renal cell carcinoma (aRCC) who were histologically diagnosed with non-clear cell carcinoma (nccRCC) and received combination immunotherapy. Oncological outcomes were compared between patients with non-clear cell RCC (nccRCC group) and those with clear cell RCC (cc-RCC group) who received either immune checkpoint inhibitor (ICI) + ICI combination therapy (ICI + ICI) or ICI + tyrosine kinase inhibitor (TKI) therapy (ICI + TKI). This retrospective study analyzed patients with aRCC who received combination immunotherapy as first-line treatment at 12 institutions between August 2018 and November 2023. The primary endpoint was the comparison of overall survival (OS) between the nccRCC and cc-RCC groups. The secondary endpoints included progression-free survival (PFS) and objective response rate (ORR) in both groups. The median follow–up periods for the nccRCC and cc-RCC groups were 17.7 and 20.4 months, respectively. The median OS was significantly shorter in the nccRCC group compared to the cc-RCC group (27.8 months vs. 62.8 months; p < 0.001). The ORRs in the nccRCC and cc-RCC groups were 52.4% and 63.6%, respectively. Among patients treated with ICI + ICI, the median OS was significantly shorter in the nccRCC group compared to the cc-RCC group (23.5 months vs. 62.8 months; p < 0.001). In the current era of ICI treatment, patients with nccRCC exhibit poorer oncological outcomes than those with cc-RCC. Indications should be evaluated thoroughly before selecting ICI + ICI treatment combinations for these patients.
Iinuma et al. (Fri,) studied this question.
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