アテゾリズマブとカボザンチニブを併用したカボザンチニブ単独治療は,前回の免疫チェックポイント阻害剤治療 (CONTACT- 03) で進行した.
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PubMedで要約を見る
まとめ
この要約は機械生成です。カボザンチニブにアテゾリズマブを添加すると,免疫チェックポイント阻害剤を投与した後に進行する転移性腎臓細胞癌の患者における無進行生存率または全生存率は改善されなかった. 臨床試験以外では有益ではないことを示唆しています.
科学分野
- 腫瘍学
- 免疫療法
- 医療腫瘍学
背景
- 免疫チェックポイント阻害剤 (ICI) は,転移性腎臓細胞癌 (mRCC) の標準的な第一線治療である.
- ICI後に進行するmRCC患者の最適な治療法は不明です.
- この研究では,アテゾリズマブをカボザンチニブに併用した患者の有効性を調べました.
研究 の 目的
- カボザンチニブにアテゾリズマブを添加することで,疾患の進行が遅れるかどうかを判断する.
- ICI後に進行するmRCC患者の生存期間を延長するかどうかを評価する.
- アテゾリズマブとカボザンチニブとの安全性を評価する.
主な方法
- CONTACT-03は3期,多センター,ランダム化,オープン試験でした.
- 522人のmRCCがICI後に進行すると,アテゾリズマブとカボザンチニブまたはカボザンチニブ単独投与が割り当てられました.
- 主要エンドポイントは,盲検による独立した中央レビューによって評価された無進行生存率 (PFS) と全生存率 (OS) でした.
主要な成果
- PFSの中央値はアテゾリズマブ- カボザンチニブで10. 6ヶ月,カボザンチニブ単独で10. 8ヶ月でした (HR1. 03; p=0. 78).
- 平均生存期間はアテゾリズマブカボザンチニブ投与で25. 7ヶ月で,カボザンチニブ単独投与では評価できなかった (HR 0. 94; p=0. 69).
- 重篤な有害事象は併用治療群でより多く発生し (48% 対 33%),治療に関連した死亡がより多く発生した (6% 対 4%).
結論
- カボザンチニブにアテゾリズマブを添加すると,ICI後に進行するmRCC患者のPFSやOSは改善されなかった.
- 併用療法により毒性が増加した.
- 臨床試験以外では,mRCCにおけるICIの連続的な使用は推奨されない.
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