Effectiveness of ICI-ICI versus ICI-TKI combinations in patients with IMDC intermediate- and poor-risk metastatic renal cell carcinoma: a sub-analysis of the MEET-URO 33 study
Year: 2026
Type: article
Abstract: BACKGROUND: Immune checkpoint inhibitor doublet (ICI-ICI) and ICI plus tyrosine kinase inhibitor (ICI-TKI) regimens are the cornerstone of treatment for metastatic renal cell carcinoma (mRCC), although no head-to-head comparisons are currently available. This study aimed to compare the real-world effectiveness of ICI-ICI versus ICI-TKI combinations in patients with intermediate- and poor-risk mRCC according to International Metastatic RCC Database Consortium (IMDC). METHODS: The Meet-URO 33 study is a multicentre retrospective-prospective registry collecting real-world data on patients with mRCC. Multivariable logistic and Cox models were built for objective response rate (ORR), PFS and OS, with a propensity score (PS) adjustment for baseline imbalances. RESULTS: Among 1497 patients, 755 were intermediate-risk (199 ICI-ICI, 556 ICI-TKI) and 312 poor-risk (77 ICI-ICI, 212 ICI-TKI). Median follow-up was 14.2 months (8.0 months and 14.5 months in poor- and intermediate-risk subgroups, respectively). In poor-risk patients, median OS was 20.3 versus 12.9 months (HR 0.87, 95% CI 0.59-1.28, p = 0.49), and median PFS was 6.7 versus 8.7 months (HR 1.10, 95% CI 0.79-1.54, p = 0.53), for ICI-ICI versus ICI-TKI, respectively. In the intermediate-risk patients treated with ICI-ICI versus ICI-TKI, median OS was 37.8 versus 35.5 months (HR 1.08; 95% CI 0.77-1.50; p = 0.65), and median PFS was 17.8 versus 18.6 months (HR 1.29, 95% CI 1.00-1.66, p = 0.050). ORR was 42.9% versus 45.8% in poor-risk patients (OR 0.72, 95% CI 0.39-1.34, p = 0.303) and 48.1% versus 54.3% in intermediate-risk patients (OR 0.71, 95% CI 0.48-1.04, p = 0.075). CONCLUSIONS: No statistically significant differences in survival or response were observed between ICI-ICI and ICI-TKI combinations in patients with IMDC intermediate- and poor-risk mRCC.
Source: Cancer Immunology Immunotherapy
Authors: Michele Maffezzoli, Alessio Signori, Alessandro Acunzo, Sebastiano Buti, Michela Bosoni, Elena Verzoni, Andrea Di Marco, Cristian Lolli, Marilena Di Napoli, Martina Fanelli, Alberto Dalla Volta, Cristina Masini, Giandomenico Roviello, Roberto Iacovelli, Alessia Mennitto, Roberto Filippi, Mariella Sorarù, Luigi Formisano, Annalisa Guida, Emanuela Fantinel, Carlo Messina, Lucia Bonomi, Sarah Scagliarini, Cecilia Nasso, Silvia Chiellino, Brigida Anna Maiorano, Filippo Deppieri, Alessia Cavo, Vincenza Conteduca, Silvia Zai, Paolo Andrea Zucali, Marcello Tucci, Francesca Vignani, Francesca La Russa, Laura Lombardo, Claudia Caserta, Federico Paolieri, Francesca Bertolotti, Pasquale Rescigno, Giuseppe Luigi Banna, Giuseppe Fornarini, Davide Bimbatti, Sara Elena Rebuzzi
Institutions: University of Parma, University of Genoa, Fondazione IRCCS Istituto Nazionale dei Tumori, Istituto Oncologico Veneto, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", University of Udine, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, University of Brescia, Azienda Sanitaria Unità Locale di Reggio Emilia, University of Florence, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Azienda Ospedaliero Universitaria Maggiore della Carita, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, University of Naples Federico II, Azienda Ospedaliera S.Maria, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Papa Giovanni XXIII, Ospedale Antonio Cardarelli, Ospedale Santa Corona, Policlinico San Matteo Fondazione, IRCCS Ospedale San Raffaele, Ospedale Villa Scassi, University of Foggia, Ospedali Riuniti di Foggia, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Humanitas University, IRCCS Humanitas Research Hospital, Azienda Sanitaria Locale di Asti, A. O. Ordine Mauriziano di Torino, Ospedale San Bortolo, Azienda ULSS 8 Berica, Azienda Usl Toscana Centro, Hospital of Prato, Ospedale San Paolo, Candiolo Cancer Institute, Newcastle University, Portsmouth Hospitals NHS Trust, University of Portsmouth, Ospedale Policlinico San Martino
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,590
Funder: Università degli Studi di Parma
OpenAlex ID: W7127412189