It remains unclear whether kidney function affects outcomes following immune checkpoint inhibitor (ICI)-based combination therapy for advanced renal cell carcinoma (RCC). We retrospectively evaluated data of 167 patients with advanced RCC, including 98 who received ICI dual combination therapy (ie, immunotherapy [IO]-IO) and 69 who received ICI combined with tyrosine kinase inhibitor (TKI) (ie, IO-TKI). In each regimen, treatment profiles were assessed according to the grade of chronic kidney disease (CKD) as defined by the KDIGO 2012 criteria. Of the 98 patients who received IO-IO, 31 (32%), 30 (31%), 15 (15%), and 22 (22%) had CKD G1/2, G3a, G3b, and G4/5, respectively. Of the 69 patients who received IO-TKI, 18 (26%), 25 (36%), and 26 (38%) had G1/2, G3a, and G3b/4/5, respectively. Regarding efficacy, progression-free survival, overall survival, or objective response rate was not different according to the CKD grade in both treatment groups ( > .05). Regarding safety, the rate of adverse events, treatment interruption, or corticosteroid administration was not different according to the CKD grade in the IO-IO group ( > .05), whereas in the IO-TKI group, the incidence of grade ≥ 3 adverse events were significantly higher ( = .0292), and the rates of ICI interruption ( = .0353) and corticosteroid administration ( = .0685) increased, according to the CKD grade. There is a differential safety but comparable efficacy profile between the IO-IO and IO-TKI regimens in patients with CKD. Further prospective studies are required to confirm these findings.

中文翻译：

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晚期肾细胞癌患者肾功能与基于免疫检查点抑制剂的联合治疗结果之间的关系

目前尚不清楚肾功能是否会影响基于免疫检查点抑制剂（ICI）的晚期肾细胞癌（RCC）联合治疗的结果。我们回顾性评估了167例晚期RCC患者的数据，其中98例接受ICI双联合治疗（即免疫疗法[IO]-IO），69例接受ICI联合酪氨酸激酶抑制剂（TKI）（即IO-TKI）。在每种治疗方案中，治疗方案均根据 KDIGO 2012 标准定义的慢性肾脏病 (CKD) 分级进行评估。在接受 IO-IO 的 98 名患者中，分别有 31 名 (32%)、30 名 (31%)、15 名 (15%) 和 22 名 (22%) 患有 CKD G1/2、G3a、G3b 和 G4/5 。在接受 IO-TKI 的 69 名患者中，分别有 18 名（26%）、25 名（36%）和 26 名（38%）为 G1/2、G3a 和 G3b/4/5。关于疗效，根据两个治疗组的 CKD 分级，无进展生存期、总生存期或客观缓解率没有差异 (> .05)。关于安全性，IO-IO 组中不良事件、治疗中断或皮质类固醇给药的发生率根据 CKD 分级（> .05）没有差异，而在 IO-TKI 组中，≥ 3 级不良事件的发生率根据 CKD 分级，事件显着增加 (= .0292)，ICI 中断率 (= .0353) 和皮质类固醇给药率 (= .0685) 增加。对于 CKD 患者，IO-IO 和 IO-TKI 方案的安全性存在差异，但疗效相当。需要进一步的前瞻性研究来证实这些发现。