Preliminary exploration of the metastatic renal cell carcinoma immune scoring for predicting the clinical efficacy of second-line targeted therapy for metastatic renal cell carcinoma
Objective To structure immunoscore system for predicting clinical efficacy of the second-line treatment in metastatic renal cell carcinoma(mRCC).Methods The clinical data of 60 patients with advanced metastatic renal cell carcinoma who developed disease progression(or drug in-tolerance)after receiving first-line targeted therapy in Zhongshan Hospital Affiliated to Fudan University from 2010 to 2021 were retrospectively analyzed.The patients were divided into everolimus group(29 cases)and axitinib group(31 cases)according to different second-line treatment.The clinical efficacy were compared.According to the immune score established in the past,the patients were divided into low risk group(27 cases),medium risk group(20 cases)and high-risk group(13 cases).The clini-cal efficacy of the three groups were compared,and thereceiver oprating characteristic(ROC)curve was analyzed with the International mRCC Database Consortium(IMDC)risk model.Results The longest follow-up period for all patients was 84.2 months.The PFS of the axitinib group was superior to that of the everolimus group(P=0.019).The OS of the axitinib group was also superior to that of the everolimus group(P=0.029).The progression free survival(PFS)of the low-risk group was superior to that of the high-risk group(P＜0.001).The overall survival(OS)of the low-risk group was also superior to that of the high-risk group(P＜0.001).ROC curve comparing immune scoring system and IMDC scoring system showed that AUC value of immune scoring system was better than IMDC risk model(0.822 vs.0.620).Conclusions Everolimus as a second-line treatment for mRCC,it may be more effective than acitinib.The immune score model can be used to predict the effect of second-line treatment of mRCC.
NETL
NSTL
万方数据
维普
