ASCO GU 2021: Immune joint targeting was successful in advanced kidney cancer, with the results of 2 years of treatment announced (KEYNOTE-426 study)

In the past two years, the treatment of first-line treatment in patients with metastatic renal cell carcinoma (mRCC) has changed dramatically.
2018, the release of CheckMate214 data proved that patients treated with nivolumab and ipilimumab had a survival advantage over schoinib in moderate and low-risk mRCC, thus ushering in the era of immunotherapy for mRCC.
javelin Renal 101, KEYNOTE-426 and CheckMate-9ER studies published later in the world have demonstrated that in the field of the disease, avelumab and axitinib, pembrolizumab and axitinib As well as nivolumab and cabo zantinib better than sunitinib (see: Lancet Oncol: Pym monoantigenic assiteni is better than the treatment of advanced kidney cancer in primary treatment than single-use sunitinib (Keynote-426).
In the plenary summary of the 2021 American Society of Clinical Oncology's Urogenespheric Cancer Symposium (ASCO GU): Renal Cell Cancer-Clinical Trial Renewal Conference, Dr. Plimack and colleagues provided a prognosis for patients who received Pym monoantigen and axiosinib treatment and completed two years of follow-up.
long-term follow-up results have just been reported: Eur J Cancer: Achtini united Pym single anti-treatment of advanced kidney cancer long-term follow-up prognosis is good! The KEYNOTE-426 study included 861 patients with advanced renal cell carcinoma who received first-line treatment, with Karnofsky Performance Score (KPS) ≥70% and Pembrolizumab (200 mg intravenous Q3W, up to 35 cycles) randomly assigned a 1:1 ratio The treatment of axitinib (5 mg oral BID) (n?432) or sunitinib treatment (50 mg oral QD, 4 weeks /2 weeks of suspension) (n=429) until the disease progresses, is not resistant to toxicity, the researcher and the patient decide to stop the drug, etc.
are layered by IMDC risk (favorable vs medium vs poor) and geographic region (North America vs Western Europe vs rest of the world).
end points are total lifetime (OS) and progress-free lifetime (PFS), and the primary endpoints are objective mitigation rate (ORR) and safety.
depending on the treatment plan, patients can deactivated pembrolizumab or axitinib and continue to use other medications.
all patients stopped using Pembrolizumab at the age of 2.
can be used continuously until progress or toxic reactions occur.
results of the previous population-wide study showed that The Pabliju mono-anti-combined axithinib significantly improved OS (HR-0.68 (95% CI:0.55-0.85) ;P-lt;0.001) and 24-month OS rates were 74% and 66%, respectively.
the middle OS in the Paboliju single resistance and axithini group and the Shoniteni group did not reach and 35.7 months, respectively.
paboliju single-resistance axiotinib significantly improved PFS compared to Schoinidini, with the two groups of mid-PFS at 15.4 months and 11.1 months respectively (HR=0.71, P.lt;0.001), with a 24-month PFS rate of 38% and 27%, respectively.
report, the authors report an exploratory subgroup analysis of KEYNOTE-426, the outcome of patients who completed a two-year Pabli juju monotherapy treatment.
129 (29.9%) of the 432 patients treated with pembrolizumab and axitinib completed two years of study.
the authors further limited the analysis to 103 patients who did not stop using axithinist because of a sexually transmitted disease.
(range) of these patients was 61 (36-82) years and 73.8 per cent for men.
the majority of patients in this sub-set suffer from moderate/low-risk diseases from the International Federation of MrCC Databases (n s 67), while 36 cases suffer from risk-effective diseases, consistent with those intended to be treated.
from random grouping to data cut-off medium (range) follow-up time is 30.1 (24.0-37.7) months.
patients who completed 2 years of study therapy did not achieve the medium overall survival rate or the medium progression survival rate as of 3 years.
85.4 per cent of patients who completed two years of treatment under the programme had an objective response, of which 16 had a full response.
in multivarivation analysis, patients under the age of 65 (OR 1.76, 95% CI 1.07-2.90) with a performance status of 90/100 (OR 2.10, 95% CI 1.03-4.24) were good (OR 4.99,95) %) patients with CI of 1.63-15.27) and moderate (OR 4.90, 95% CI 1.67-14.41) were more likely to complete two years of treatment in patients with sarcoma-like characteristics (OR 2.19, 95% CI 1.08-4.43).
60.2% of patients experienced adverse events associated with level 3-4 treatment without any level 5 events.
exploratory analysis showed that a large proportion of patients in the pembrolizumab and axitinib groups were able to complete 2 years of pembrolizumab treatment with ongoing clinical benefits.