Clinical efficacy of third-and later-line regimen of nivolumab plus statins in the treatment of patients with metastatic renal cell carcinoma and their prognosis factors
Objective:To evaluate the clinical efficacy of nivolumab plus atorvastatin as a third-or later-line treatment for patients with metastatic renal cell carcinoma(mRCC).Methods:A total of 137 patients with mRCC who were histopathologically confirmed and failed in clinical second-line therapy regimens at Yongzhou Center Hospital from January 2018 to December 2022 were retrospectively selected.Patients with mRCC were divided in-to the single treatment group(STG)of nivolumab monotherapy,and the combined treatment group(CTG)of niv-olumab in combination with atorvastatin.The primary outcomes of interest were objective response rate(ORR)and disease control rate(DCR),progression-free survival(PFS),and overall survival(OS).Survival data were an-alyzed using the Kaplan-Meier method,and the log-rank test was performed.Additionally,Cox proportional haz-ard regression was used to explore the effect of different clinical features on PFS and OS.Results:Of the 137 pa-tients with mRCC included in the research,91 patients received nivolumab,and 46 patients received nivolumab plus atorvastatin.The ORR of CTG and STG were 28.26％and 20.88％,and the DCR were 56.52％and 37.36％,respectively.The median PFS(mPFS)and median OS(mOS)in CTG were higher than those in the STG(8.92 months vs 6.80 months,P＜0.05;24.22 months vs 10.63 months,P＜0.05;respectively).No pre-vious nephrectomy,more than two metastatic sites,and＞third-line treatment were independent risk factors for the mPFS of patients with mRCC,and no previous nephrectomy and＞third-line treatment were independent risk factors for the mOS of patients with mRCC.Conclusion:Nivolumab combined with atorvastatin as the third-or later-line regimen greatly prolonged PFS and OS of mRCC patients.A prospective clinical trial is warranted.
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