Efficacy of the combination of pembrolizumab and axitinib in the treatment of renal cell carcinoma associated with chronic kidney disease

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Abstract

Background. Information on choosing the optimal treatment regimen for renal cell carcinoma (RCC) associated with chronic kidney disease (CKD) is limited. It seems relevant to study the actual practice of providing oncological care to patients suffering from RCC against the background CKD.

Objective. Evaluation of the effectiveness and safety of therapy for renal cell carcinoma (RCC) against the background of CKD with a combination of pembrolizumab and axitinib.

Methods. A retrospective study with the participation of 194 patients with RCC against the background of CKD who received treatment at the Pletnev City Clinical Hospital in 2020–2022 was carried out. Patients were divided into groups according to the IMDC prognostic model and renal function status. The control group consisted of similar patients with conditionally preserved renal filtration function. The effectiveness of therapy was assessed by median progression-free survival (PFS) and overall survival (OS).

Results. The probability of complete or partial response, as well as OS with a favorable and intermediate prognosis in patients with concomitant CKD were comparable with the control group (P>0.05). The negative impact of CKD can be seen only with an unfavorable prognosis, where the probability of progression was higher than in the control group (21.4 and 7.7%, respectively; P<0.05). Side effects requiring discontinuation of therapy were observed in 5.9–8.8% of patients without significant differences between groups (P>0.05).

Conclusion. In CKD (stage II–III), RCC therapy, including pembrolizumab and axitinib, demonstrated comparable efficacy and safety compared to patients with conditionally preserved renal function.

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About the authors

T. N. Trofimtseva

Moscow Loginova Clinical Research Center

Email: bit.t@mail.ru
ORCID iD: 0009-0001-9324-878X
SPIN-code: 9204-9426
Russian Federation, Moscow

S. K. Yarovoy

Lopatkin Research Institute of Urology and Interventional Radiology– Branch of the National Medical Research Radiological Center

Email: bit.t@mail.ru
ORCID iD: 0000-0003-4543-1480
SPIN-code: 2848-7750
Russian Federation, Moscow

A. A. Gritskevich

Vishnevsky National Medical Research Center for Surgery; Patrice Lumumba Peoples’ Friendship University of Russia

Email: bit.t@mail.ru
ORCID iD: 0000-0002-5160-925X
SPIN-code: 2128-7536
Russian Federation, Moscow; Moscow

T. P. Baytman

Vishnevsky National Medical Research Center for Surgery; Patrice Lumumba Peoples’ Friendship University of Russia

Author for correspondence.
Email: bit.t@mail.ru
ORCID iD: 0000-0002-3646-1664
SPIN-code: 4684-3230

Researcher at the Department of Surgical Treatment of Urological Diseases, Teaching Assistant at the Department of Urology and Operative Nephrology with a Course in Oncourology, Patrice Lumumba Peoples’ Friendship University of Russia

Russian Federation, Moscow; Moscow

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