Factores clínicos de los pacientes en cáncer renal de células claras manejado con inmunoterapia en primera línea en el Instituto Nacional de Cancerología entre 2018 y 2023, Bogotá–Colombia

Resumen Introducción: El cáncer renal de células claras (CRCC) es una de las malignidades más comunes del sistema urinario. Hasta el 30% se presenta con metástasis local o a distancia mientras que el 20% de los que reciben diagnóstico inicial de enfermedad localizada desarrollaran metástasis durante...

Full description

Autores:
Zapata Laguado, Martin Ignacio
Gonzalez Blanco , Mariafernanda
Tipo de recurso:
https://purl.org/coar/resource_type/c_7a1f
Fecha de publicación:
2025
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
spa
OAI Identifier:
oai:repositorio.unbosque.edu.co:20.500.12495/13928
Acceso en línea:
https://hdl.handle.net/20.500.12495/13928
Palabra clave:
Carcinoma de Células Renales;
Neoplasias Renales
Inmunoterapia
Nefrectomía
Carcinoma, Renal Cell
Kidney Neoplasms
Immunotherapy
Nephrectomy
QZ 200
Rights
License
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
id UNBOSQUE2_3b73f4c97acb0a79b1569c82cb275c0c
oai_identifier_str oai:repositorio.unbosque.edu.co:20.500.12495/13928
network_acronym_str UNBOSQUE2
network_name_str Repositorio U. El Bosque
repository_id_str
dc.title.none.fl_str_mv Factores clínicos de los pacientes en cáncer renal de células claras manejado con inmunoterapia en primera línea en el Instituto Nacional de Cancerología entre 2018 y 2023, Bogotá–Colombia
dc.title.translated.none.fl_str_mv Clinical factors of patients with clear cell renal cancer managed with first-line immunotherapy at the National Cancer Institute between 2018 and 2023, Bogotá–Colombia
title Factores clínicos de los pacientes en cáncer renal de células claras manejado con inmunoterapia en primera línea en el Instituto Nacional de Cancerología entre 2018 y 2023, Bogotá–Colombia
spellingShingle Factores clínicos de los pacientes en cáncer renal de células claras manejado con inmunoterapia en primera línea en el Instituto Nacional de Cancerología entre 2018 y 2023, Bogotá–Colombia
Carcinoma de Células Renales;
Neoplasias Renales
Inmunoterapia
Nefrectomía
Carcinoma, Renal Cell
Kidney Neoplasms
Immunotherapy
Nephrectomy
QZ 200
title_short Factores clínicos de los pacientes en cáncer renal de células claras manejado con inmunoterapia en primera línea en el Instituto Nacional de Cancerología entre 2018 y 2023, Bogotá–Colombia
title_full Factores clínicos de los pacientes en cáncer renal de células claras manejado con inmunoterapia en primera línea en el Instituto Nacional de Cancerología entre 2018 y 2023, Bogotá–Colombia
title_fullStr Factores clínicos de los pacientes en cáncer renal de células claras manejado con inmunoterapia en primera línea en el Instituto Nacional de Cancerología entre 2018 y 2023, Bogotá–Colombia
title_full_unstemmed Factores clínicos de los pacientes en cáncer renal de células claras manejado con inmunoterapia en primera línea en el Instituto Nacional de Cancerología entre 2018 y 2023, Bogotá–Colombia
title_sort Factores clínicos de los pacientes en cáncer renal de células claras manejado con inmunoterapia en primera línea en el Instituto Nacional de Cancerología entre 2018 y 2023, Bogotá–Colombia
dc.creator.fl_str_mv Zapata Laguado, Martin Ignacio
Gonzalez Blanco , Mariafernanda
dc.contributor.advisor.none.fl_str_mv Zapata Laguado, Martin Ignacio
dc.contributor.author.none.fl_str_mv Zapata Laguado, Martin Ignacio
Gonzalez Blanco , Mariafernanda
dc.contributor.orcid.none.fl_str_mv Zapata Laguado, Martin Ignacio [ https://orcid.org/0000-0002-2781-8406]
Gonzalez Blanco, Mariafernanda [ https://orcid.org/0009-0001-7154-7834]
dc.subject.none.fl_str_mv Carcinoma de Células Renales;
Neoplasias Renales
Inmunoterapia
Nefrectomía
topic Carcinoma de Células Renales;
Neoplasias Renales
Inmunoterapia
Nefrectomía
Carcinoma, Renal Cell
Kidney Neoplasms
Immunotherapy
Nephrectomy
QZ 200
dc.subject.keywords.none.fl_str_mv Carcinoma, Renal Cell
Kidney Neoplasms
Immunotherapy
Nephrectomy
dc.subject.nlm.none.fl_str_mv QZ 200
description Resumen Introducción: El cáncer renal de células claras (CRCC) es una de las malignidades más comunes del sistema urinario. Hasta el 30% se presenta con metástasis local o a distancia mientras que el 20% de los que reciben diagnóstico inicial de enfermedad localizada desarrollaran metástasis durante el seguimiento. La evaluación del riesgo y la elección del tratamiento adecuado son cruciales para su manejo. Este estudio pretende disminuir la brecha de información en Colombia y Latino América. Métodos: Se realizó un estudio observacional de corte transversal, incluyendo pacientes atendidos entre el 1 de enero de 2018 y el 31 de diciembre de 2023 en el Instituto Nacional de Cancerología en Bogotá, Colombia. Resultados: Se incluyeron 27 pacientes con una mediana de edad de 54 años, la mayoría hombres (78%), fumadores (48.1%) con una buena condición funcional (karnofsky superior a 80% : 85.5%). El 59.3% presentaba sobrepeso con un IMC superior a 25 y el 22.2% se encontraba en rango de obesidad superando un IMC de 30. El 66.7% de los pacientes debuto con enfermedad metastásica con compromiso principalmente a nivel pulmonar (48.1%) y óseo (40.7%). El 18.5 % de la población tenía riesgo favorable, el 48.1% riesgo intermedio y el 33.3% riesgo desfavorable (International Metastatic RCC Database Consortium IMDC). Los esquemas de tratamiento más utilizados como primera línea fueron nivolumab + ipilimumab (63%), pembrolizumab + axitinib (18,5%) y pembrolizumab + lenvatinib (14,8%). Al realizar un seguimiento mínimo de 6 meses 40,7% de los pacientes presento progresión de su enfermedad requiriendo cambio de línea de tratamiento a inhibidor de tirosin kinasa (TKI), el mas utilizado fue cabozantinib (18,5%). Conclusiones: Nuestros resultados contribuyen a la comprensión del manejo del cáncer renal de células claras metastásico en Colombia, destacando la importancia de la inmunoterapia como opción terapéutica. Mostrando similitudes con la literatura publicada previamente. Se necesitan más estudios para optimizar el tratamiento y mejorar los resultados.
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-02-11T20:32:59Z
dc.date.available.none.fl_str_mv 2025-02-11T20:32:59Z
dc.date.issued.none.fl_str_mv 2025-01
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.local.spa.fl_str_mv Tesis/Trabajo de grado - Monografía - Especialización
dc.type.coar.none.fl_str_mv https://purl.org/coar/resource_type/c_7a1f
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/bachelorThesis
dc.type.coarversion.none.fl_str_mv https://purl.org/coar/version/c_ab4af688f83e57aa
format https://purl.org/coar/resource_type/c_7a1f
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/20.500.12495/13928
dc.identifier.instname.spa.fl_str_mv instname:Universidad El Bosque
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional Universidad El Bosque
dc.identifier.repourl.none.fl_str_mv repourl:https://repositorio.unbosque.edu.co
url https://hdl.handle.net/20.500.12495/13928
identifier_str_mv instname:Universidad El Bosque
reponame:Repositorio Institucional Universidad El Bosque
repourl:https://repositorio.unbosque.edu.co
dc.language.iso.fl_str_mv spa
language spa
dc.relation.references.none.fl_str_mv 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209–49.
2. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022 Jan;72(1):7–33.
3. Hsieh JJ, Purdue MP, Signoretti S, Swanton C, Albiges L, Schmidinger M, et al. Renal cell carcinoma. Nat Rev Dis Primers. 2017 Mar 9;3
4. Porta C, Cosmai L, Leibovich BC, Powles T, Gallieni M, Bex A. The adjuvant treatment of kidney cancer: a multidisciplinary outlook. Nat Rev Nephrol. 2019 Jul 1;15(7):423–33.
5. Schödel J, Grampp S, Maher ER, Moch H, Ratcliffe PJ, Russo P, et al. Hypoxia, hypoxia-inducible transcription factors, and renal cancer. Eur Urol. 2016 Apr 1;69(4):646–57.
6. Yang J, Wang K, Yang Z. Treatment strategies for clear cell renal cell carcinoma: Past, present and future. Front Oncol [Internet]. 2023 [cited 2024 Mar 19];13. Available from: /pmc/articles/PMC10070676/
7. Sánchez-Gastaldo A, Kempf E, González del Alba A, Duran I. Systemic treatment of renal cell cancer: A comprehensive review. Cancer Treat Rev. 2017 Nov 1;60:77–89.
8. Choueiri TK, Powles T, Burotto M, Escudier B, Bourlon MT, Zurawski B, et al. Nivolumab plus Cabozantinib versus Sunitinib for Advanced Renal-Cell Carcinoma. New England Journal of Medicine. 2021 Mar 4;384(9):829–41.
9. Rini BI, Plimack ER, Stus V, Waddell T, Gafanov R, Pouliot F, et al. Pembrolizumab (pembro) plus axitinib (axi) versus sunitinib as first-line therapy for advanced clear cell renal cell carcinoma (ccRCC): Results from 42-month follow-up of KEYNOTE-426. Journal of Clinical Oncology. 2021 May 20;39(15_suppl):4500–4500.
10. Motzer RJ, Porta C, Eto M, Powles T, Grünwald V, Hutson TE, et al. Phase 3 trial of lenvatinib (LEN) plus pembrolizumab (PEMBRO) or everolimus (EVE) versus sunitinib (SUN) monotherapy as a first-line treatment for patients (pts) with advanced renal cell carcinoma (RCC) (CLEAR study). Journal of Clinical Oncology. 2021 Feb 20;39(6_suppl):269–269.
11. Haanen JBAG, Larkin J, Choueiri TK, Albiges L, Rini BI, Atkins MB, et al. Efficacy of avelumab + axitinib (A + Ax) versus sunitinib (S) by IMDC risk group in advanced renal cell carcinoma (aRCC): Extended follow-up results from JAVELIN Renal 101. Journal of Clinical Oncology. 2021 May 20;39(15_suppl):4574–4574.
12. Elaidi R, Phan L, Borchiellini D, Barthelemy P, Ravaud A, Oudard S, et al. Comparative efficacy of first-line immune-based combination therapies in metastatic renal cell carcinoma: A systematic review and network meta-analysis. Cancers (Basel). 2020 Jun 1;12(6):1–13.
13. Powles T, Plimack ER, Soulières D, Waddell T, Stus V, Gafanov R, et al. Pembrolizumab plus axitinib versus sunitinib monotherapy as first-line treatment of advanced renal cell carcinoma (KEYNOTE-426): extended follow-up from a randomised, open-label, phase 3 trial. Lancet Oncol. 2020 Dec 1;21(12):1563–73.
14. Rini BI, Plimack ER, Stus V, Gafanov R, Hawkins R, Nosov D, et al. Pembrolizumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma. New England Journal of Medicine. 2019 Mar 21;380(12):1116–27.
15. Choueiri TK, Motzer RJ, Rini BI, Haanen J, Campbell MT, Venugopal B, et al. Updated efficacy results from the JAVELIN Renal 101 trial: first-line avelumab plus axitinib versus sunitinib in patients with advanced renal cell carcinoma. Annals of Oncology. 2020 Aug 1;31(8):1030–9.
16. Motzer RJ, Penkov K, Haanen J, Rini B, Albiges L, Campbell MT, et al. Avelumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma. New England Journal of Medicine. 2019 Mar 21;380(12):1103–15.
17. Albiges L, Tannir NM, Burotto M, McDermott D, Plimack ER, Barthélémy P, et al. Nivolumab plus ipilimumab versus sunitinib for first-line treatment of advanced renal cell carcinoma: Extended 4-year follow-up of the phase III CheckMate 214 trial. ESMO Open. 2020 Nov 27;5(6).
18. Motzer RJ, Tannir NM, McDermott DF, Arén Frontera O, Melichar B, Choueiri TK, et al. Nivolumab plus Ipilimumab versus Sunitinib in Advanced Renal-Cell Carcinoma. New England Journal of Medicine. 2018 Apr 5;378(14):1277–90.
19. Powles T, Albiges L, Bex A, Grünwald V, Porta C, Procopio G, et al. ESMO Clinical Practice Guideline update on the use of immunotherapy in early stage and advanced renal cell carcinoma. Annals of Oncology. 2021 Dec 1;32(12):1511–9.
20. Escudier B, Porta C, Schmidinger M, Rioux-Leclercq N, Bex A, Khoo V, et al. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2019 May 1;30(5):706–20.
21. National Comprehensive Cancer Network. Kindney cancer (Version 3.2024) [Internet]. [cited 2024 Mar 30]. Available from: https://www.nccn.org/professionals/physician_gls/pdf/kidney.pdf
22. Ravindranathan D, Master VA, Bilen MA. Inflammatory markers in cancer immunotherapy. Biology (Basel). 2021;10(4).
23. Zhuang TZ, Case K, Olsen TA, Brown JT, Carthon BC, Kucuk O, et al. Metastatic Clear-Cell Renal Cell Carcinoma in the Era of Immune Checkpoint Inhibitors: Therapies and Ongoing Trials. Cancers (Basel). 2022 Jun 1;14(12).
24. Zhuang TZ, Ravindranathan D, Liu Y, Martini DJ, Brown JT, Nazha B, et al. Baseline Neutrophil-to-Eosinophil Ratio Is Associated with Outcomes in Metastatic Renal Cell Carcinoma Treated with Immune Checkpoint Inhibitors. Oncologist. 2023 Mar 17;28(3):239–45.
25. Takemura K, Yonekura S, Downey LE, Evangelopoulos D, Heng DYC. Impact of Body Mass Index on Survival Outcomes of Patients with Metastatic Renal Cell Carcinoma in the Immuno-oncology Era: A Systematic Review and Meta-analysis. Eur Urol Open Sci. 2022 May 1;39:62–71.
26. Hakimi AA, Furberg H, Zabor EC, Jacobsen A, Schultz N, Ciriello G, et al. An Epidemiologic and Genomic Investigation Into the Obesity Paradox in Renal Cell Carcinoma. JNCI: Journal of the National Cancer Institute. 2013 Dec 18;105(24):1862–70.
27. Lalani AKA, Bakouny Z, Farah S, Donskov F, Dudani S, Heng DYC, et al. Assessment of Immune Checkpoint Inhibitors and Genomic Alterations by Body Mass Index in Advanced Renal Cell Carcinoma. JAMA Oncol. 2021 May 1;7(5):773.
28. Lalani AKA, McGregor BA, Albiges L, Choueiri TK, Motzer R, Powles T, et al. Systemic Treatment of Metastatic Clear Cell Renal Cell Carcinoma in 2018: Current Paradigms, Use of Immunotherapy, and Future Directions. Eur Urol. 2019 Jan 1;75(1):100–10.
29. Salgia NJ, Dara Y, Bergerot P, Salgia M, Pal SK. The Changing Landscape of Management of Metastatic Renal Cell Carcinoma: Current Treatment Options and Future Directions. Curr Treat Options Oncol. 2019 May 1;20(5).
30. Rathmell WK, Rumble RB, Van Veldhuizen PJ, Al-Ahmadie H, Emamekhoo H, Hauke RJ, et al. Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline. Journal of Clinical Oncology [Internet]. 2022 May 1 [cited 2024 Mar 19];72. Available from: https://ascopubs.org/doi/10.1200/JCO.22.00868
31. Heng DYC, Xie W, Regan MM, Warren MA, Golshayan AR, Sahi C, et al. Prognostic Factors for Overall Survival in Patients With Metastatic Renal Cell Carcinoma Treated With Vascular Endothelial Growth Factor–Targeted Agents: Results From a Large, Multicenter Study. Journal of Clinical Oncology. 2009 Dec 1;27(34):5794–9.
32. Heng DY, Xie W, Regan MM, Harshman LC, Bjarnason GA, Vaishampayan UN, et al. External validation and comparison with other models of the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model: a population-based study. Lancet Oncol. 2013 Feb;14(2):141–8.
33. Ged Y, Sanchez A, Patil S, Knezevic A, Stein E, Petruzella S, et al. Associations between Pretreatment Body Composition Features and Clinical Outcomes among Patients with Metastatic Clear Cell Renal Cell Carcinoma Treated with Immune Checkpoint Blockade. Clinical Cancer Research. 2022 Dec 1;28(23):5180–9.
34. Shah, N. J., Sura, S. D., Shinde, R., Shi, J., Singhal, P. K., Robert, N. J., Vogelzang, N. J., Perini, R. F., & Motzer, R. J. (2023). Real-world treatment patterns and clinical outcomes for metastatic renal cell carcinoma in the current treatment era. European Urology Open Science, 49, 110–118. https://doi.org/10.1016/j.euros.2022.12.015
dc.rights.en.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.uri.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.local.spa.fl_str_mv Acceso abierto
dc.rights.accessrights.none.fl_str_mv https://purl.org/coar/access_right/c_abf2
rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
Acceso abierto
https://purl.org/coar/access_right/c_abf2
http://purl.org/coar/access_right/c_abf2
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.program.spa.fl_str_mv Especialización en Oncología Clínica
dc.publisher.grantor.spa.fl_str_mv Universidad El Bosque
dc.publisher.faculty.spa.fl_str_mv Facultad de Medicina
institution Universidad El Bosque
bitstream.url.fl_str_mv https://repositorio.unbosque.edu.co/bitstreams/52a6fbf3-cd88-42bb-a25b-e89333949cfe/download
https://repositorio.unbosque.edu.co/bitstreams/8f6cf55f-152d-4564-b802-70f49118bf11/download
https://repositorio.unbosque.edu.co/bitstreams/ba2b826c-b424-45a4-a1aa-8ec10baa47de/download
https://repositorio.unbosque.edu.co/bitstreams/86399330-a527-4d03-94f7-41d634c2b6d9/download
https://repositorio.unbosque.edu.co/bitstreams/79ef12bf-9dcb-493a-9530-acbb93394890/download
https://repositorio.unbosque.edu.co/bitstreams/5cf1e790-2e1b-4e17-8730-40997ad556ac/download
https://repositorio.unbosque.edu.co/bitstreams/ca898f65-ccb1-4651-8831-34b5849f3814/download
bitstream.checksum.fl_str_mv 88db8d7b6bf1949d090e6b8104432c8c
17cc15b951e7cc6b3728a574117320f9
3da9eaa05a851300241015b58cdedd5b
9bf4ece461e1b6e40fb1386a80bcdc07
3b6ce8e9e36c89875e8cf39962fe8920
2304d3da80c0c136fe689981b668832f
9377f9f46fa3d2fa1118ab01c6d2e104
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
MD5
MD5
MD5
MD5
repository.name.fl_str_mv Repositorio Institucional Universidad El Bosque
repository.mail.fl_str_mv bibliotecas@biteca.com
_version_ 1828164394437050368
spelling Zapata Laguado, Martin IgnacioZapata Laguado, Martin IgnacioGonzalez Blanco , MariafernandaZapata Laguado, Martin Ignacio [ https://orcid.org/0000-0002-2781-8406]Gonzalez Blanco, Mariafernanda [ https://orcid.org/0009-0001-7154-7834]2025-02-11T20:32:59Z2025-02-11T20:32:59Z2025-01https://hdl.handle.net/20.500.12495/13928instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coResumen Introducción: El cáncer renal de células claras (CRCC) es una de las malignidades más comunes del sistema urinario. Hasta el 30% se presenta con metástasis local o a distancia mientras que el 20% de los que reciben diagnóstico inicial de enfermedad localizada desarrollaran metástasis durante el seguimiento. La evaluación del riesgo y la elección del tratamiento adecuado son cruciales para su manejo. Este estudio pretende disminuir la brecha de información en Colombia y Latino América. Métodos: Se realizó un estudio observacional de corte transversal, incluyendo pacientes atendidos entre el 1 de enero de 2018 y el 31 de diciembre de 2023 en el Instituto Nacional de Cancerología en Bogotá, Colombia. Resultados: Se incluyeron 27 pacientes con una mediana de edad de 54 años, la mayoría hombres (78%), fumadores (48.1%) con una buena condición funcional (karnofsky superior a 80% : 85.5%). El 59.3% presentaba sobrepeso con un IMC superior a 25 y el 22.2% se encontraba en rango de obesidad superando un IMC de 30. El 66.7% de los pacientes debuto con enfermedad metastásica con compromiso principalmente a nivel pulmonar (48.1%) y óseo (40.7%). El 18.5 % de la población tenía riesgo favorable, el 48.1% riesgo intermedio y el 33.3% riesgo desfavorable (International Metastatic RCC Database Consortium IMDC). Los esquemas de tratamiento más utilizados como primera línea fueron nivolumab + ipilimumab (63%), pembrolizumab + axitinib (18,5%) y pembrolizumab + lenvatinib (14,8%). Al realizar un seguimiento mínimo de 6 meses 40,7% de los pacientes presento progresión de su enfermedad requiriendo cambio de línea de tratamiento a inhibidor de tirosin kinasa (TKI), el mas utilizado fue cabozantinib (18,5%). Conclusiones: Nuestros resultados contribuyen a la comprensión del manejo del cáncer renal de células claras metastásico en Colombia, destacando la importancia de la inmunoterapia como opción terapéutica. Mostrando similitudes con la literatura publicada previamente. Se necesitan más estudios para optimizar el tratamiento y mejorar los resultados.Instituto Nacional de CancerologíaEspecialista en Oncología ClínicaEspecializaciónAbstract Introduction: Clear cell renal carcinoma (ccRCC) is one of the most common malignancies of the urinary system. Up to 30% present with local or distant metastasis, while 20% of those initially diagnosed with localized disease develop metastasis during follow-up. Risk assessment and appropriate treatment selection are crucial for management. This study aims to bridge the information gap in Colombia and Latin America. Methods: A cross-sectional observational study was conducted, including patients treated between January 1, 2018, and December 31, 2023, at the National Cancer Institute in Bogotá, Colombia. Results: Twenty-seven patients were included, with a median age of 54 years, mostly men (78%), smokers (48.1%), and good functional status (Karnofsky >80%: 85.5%). 59.3% were overweight (BMI >25), and 22.2% obese (BMI >30). 66.7% presented with metastatic disease, mainly pulmonary (48.1%) and bone (40.7%) involvement. 18.5% had favorable risk, 48.1% intermediate risk, and 33.3% poor risk (International Metastatic RCC Database Consortium IMDC). First-line treatment schemes were nivolumab + ipilimumab (63%), pembrolizumab + axitinib (18.5%), and pembrolizumab + lenvatinib (14.8%). After a minimum 6-month follow-up, 40.7% progressed, requiring a change to tyrosine kinase inhibitors (TKIs), with cabozantinib being the most used (18.5%). Conclusions: Our results contribute to the understanding of metastatic clear cell renal cell carcinoma (ccRCC) management in Colombia, highlighting the importance of immunotherapy. Similarities with previously published literature were observed. Further studies are needed to optimize treatment and improve outcomes.application/pdfAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Acceso abiertohttps://purl.org/coar/access_right/c_abf2http://purl.org/coar/access_right/c_abf2Carcinoma de Células Renales;Neoplasias RenalesInmunoterapiaNefrectomíaCarcinoma, Renal CellKidney NeoplasmsImmunotherapyNephrectomyQZ 200Factores clínicos de los pacientes en cáncer renal de células claras manejado con inmunoterapia en primera línea en el Instituto Nacional de Cancerología entre 2018 y 2023, Bogotá–ColombiaClinical factors of patients with clear cell renal cancer managed with first-line immunotherapy at the National Cancer Institute between 2018 and 2023, Bogotá–ColombiaEspecialización en Oncología ClínicaUniversidad El BosqueFacultad de MedicinaTesis/Trabajo de grado - Monografía - Especializaciónhttps://purl.org/coar/resource_type/c_7a1fhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesishttps://purl.org/coar/version/c_ab4af688f83e57aa1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209–49.2. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022 Jan;72(1):7–33.3. Hsieh JJ, Purdue MP, Signoretti S, Swanton C, Albiges L, Schmidinger M, et al. Renal cell carcinoma. Nat Rev Dis Primers. 2017 Mar 9;34. Porta C, Cosmai L, Leibovich BC, Powles T, Gallieni M, Bex A. The adjuvant treatment of kidney cancer: a multidisciplinary outlook. Nat Rev Nephrol. 2019 Jul 1;15(7):423–33.5. Schödel J, Grampp S, Maher ER, Moch H, Ratcliffe PJ, Russo P, et al. Hypoxia, hypoxia-inducible transcription factors, and renal cancer. Eur Urol. 2016 Apr 1;69(4):646–57.6. Yang J, Wang K, Yang Z. Treatment strategies for clear cell renal cell carcinoma: Past, present and future. Front Oncol [Internet]. 2023 [cited 2024 Mar 19];13. Available from: /pmc/articles/PMC10070676/7. Sánchez-Gastaldo A, Kempf E, González del Alba A, Duran I. Systemic treatment of renal cell cancer: A comprehensive review. Cancer Treat Rev. 2017 Nov 1;60:77–89.8. Choueiri TK, Powles T, Burotto M, Escudier B, Bourlon MT, Zurawski B, et al. Nivolumab plus Cabozantinib versus Sunitinib for Advanced Renal-Cell Carcinoma. New England Journal of Medicine. 2021 Mar 4;384(9):829–41.9. Rini BI, Plimack ER, Stus V, Waddell T, Gafanov R, Pouliot F, et al. Pembrolizumab (pembro) plus axitinib (axi) versus sunitinib as first-line therapy for advanced clear cell renal cell carcinoma (ccRCC): Results from 42-month follow-up of KEYNOTE-426. Journal of Clinical Oncology. 2021 May 20;39(15_suppl):4500–4500.10. Motzer RJ, Porta C, Eto M, Powles T, Grünwald V, Hutson TE, et al. Phase 3 trial of lenvatinib (LEN) plus pembrolizumab (PEMBRO) or everolimus (EVE) versus sunitinib (SUN) monotherapy as a first-line treatment for patients (pts) with advanced renal cell carcinoma (RCC) (CLEAR study). Journal of Clinical Oncology. 2021 Feb 20;39(6_suppl):269–269.11. Haanen JBAG, Larkin J, Choueiri TK, Albiges L, Rini BI, Atkins MB, et al. Efficacy of avelumab + axitinib (A + Ax) versus sunitinib (S) by IMDC risk group in advanced renal cell carcinoma (aRCC): Extended follow-up results from JAVELIN Renal 101. Journal of Clinical Oncology. 2021 May 20;39(15_suppl):4574–4574.12. Elaidi R, Phan L, Borchiellini D, Barthelemy P, Ravaud A, Oudard S, et al. Comparative efficacy of first-line immune-based combination therapies in metastatic renal cell carcinoma: A systematic review and network meta-analysis. Cancers (Basel). 2020 Jun 1;12(6):1–13.13. Powles T, Plimack ER, Soulières D, Waddell T, Stus V, Gafanov R, et al. Pembrolizumab plus axitinib versus sunitinib monotherapy as first-line treatment of advanced renal cell carcinoma (KEYNOTE-426): extended follow-up from a randomised, open-label, phase 3 trial. Lancet Oncol. 2020 Dec 1;21(12):1563–73.14. Rini BI, Plimack ER, Stus V, Gafanov R, Hawkins R, Nosov D, et al. Pembrolizumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma. New England Journal of Medicine. 2019 Mar 21;380(12):1116–27.15. Choueiri TK, Motzer RJ, Rini BI, Haanen J, Campbell MT, Venugopal B, et al. Updated efficacy results from the JAVELIN Renal 101 trial: first-line avelumab plus axitinib versus sunitinib in patients with advanced renal cell carcinoma. Annals of Oncology. 2020 Aug 1;31(8):1030–9.16. Motzer RJ, Penkov K, Haanen J, Rini B, Albiges L, Campbell MT, et al. Avelumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma. New England Journal of Medicine. 2019 Mar 21;380(12):1103–15.17. Albiges L, Tannir NM, Burotto M, McDermott D, Plimack ER, Barthélémy P, et al. Nivolumab plus ipilimumab versus sunitinib for first-line treatment of advanced renal cell carcinoma: Extended 4-year follow-up of the phase III CheckMate 214 trial. ESMO Open. 2020 Nov 27;5(6).18. Motzer RJ, Tannir NM, McDermott DF, Arén Frontera O, Melichar B, Choueiri TK, et al. Nivolumab plus Ipilimumab versus Sunitinib in Advanced Renal-Cell Carcinoma. New England Journal of Medicine. 2018 Apr 5;378(14):1277–90.19. Powles T, Albiges L, Bex A, Grünwald V, Porta C, Procopio G, et al. ESMO Clinical Practice Guideline update on the use of immunotherapy in early stage and advanced renal cell carcinoma. Annals of Oncology. 2021 Dec 1;32(12):1511–9.20. Escudier B, Porta C, Schmidinger M, Rioux-Leclercq N, Bex A, Khoo V, et al. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2019 May 1;30(5):706–20.21. National Comprehensive Cancer Network. Kindney cancer (Version 3.2024) [Internet]. [cited 2024 Mar 30]. Available from: https://www.nccn.org/professionals/physician_gls/pdf/kidney.pdf22. Ravindranathan D, Master VA, Bilen MA. Inflammatory markers in cancer immunotherapy. Biology (Basel). 2021;10(4).23. Zhuang TZ, Case K, Olsen TA, Brown JT, Carthon BC, Kucuk O, et al. Metastatic Clear-Cell Renal Cell Carcinoma in the Era of Immune Checkpoint Inhibitors: Therapies and Ongoing Trials. Cancers (Basel). 2022 Jun 1;14(12).24. Zhuang TZ, Ravindranathan D, Liu Y, Martini DJ, Brown JT, Nazha B, et al. Baseline Neutrophil-to-Eosinophil Ratio Is Associated with Outcomes in Metastatic Renal Cell Carcinoma Treated with Immune Checkpoint Inhibitors. Oncologist. 2023 Mar 17;28(3):239–45.25. Takemura K, Yonekura S, Downey LE, Evangelopoulos D, Heng DYC. Impact of Body Mass Index on Survival Outcomes of Patients with Metastatic Renal Cell Carcinoma in the Immuno-oncology Era: A Systematic Review and Meta-analysis. Eur Urol Open Sci. 2022 May 1;39:62–71.26. Hakimi AA, Furberg H, Zabor EC, Jacobsen A, Schultz N, Ciriello G, et al. An Epidemiologic and Genomic Investigation Into the Obesity Paradox in Renal Cell Carcinoma. JNCI: Journal of the National Cancer Institute. 2013 Dec 18;105(24):1862–70.27. Lalani AKA, Bakouny Z, Farah S, Donskov F, Dudani S, Heng DYC, et al. Assessment of Immune Checkpoint Inhibitors and Genomic Alterations by Body Mass Index in Advanced Renal Cell Carcinoma. JAMA Oncol. 2021 May 1;7(5):773.28. Lalani AKA, McGregor BA, Albiges L, Choueiri TK, Motzer R, Powles T, et al. Systemic Treatment of Metastatic Clear Cell Renal Cell Carcinoma in 2018: Current Paradigms, Use of Immunotherapy, and Future Directions. Eur Urol. 2019 Jan 1;75(1):100–10.29. Salgia NJ, Dara Y, Bergerot P, Salgia M, Pal SK. The Changing Landscape of Management of Metastatic Renal Cell Carcinoma: Current Treatment Options and Future Directions. Curr Treat Options Oncol. 2019 May 1;20(5).30. Rathmell WK, Rumble RB, Van Veldhuizen PJ, Al-Ahmadie H, Emamekhoo H, Hauke RJ, et al. Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline. Journal of Clinical Oncology [Internet]. 2022 May 1 [cited 2024 Mar 19];72. Available from: https://ascopubs.org/doi/10.1200/JCO.22.0086831. Heng DYC, Xie W, Regan MM, Warren MA, Golshayan AR, Sahi C, et al. Prognostic Factors for Overall Survival in Patients With Metastatic Renal Cell Carcinoma Treated With Vascular Endothelial Growth Factor–Targeted Agents: Results From a Large, Multicenter Study. Journal of Clinical Oncology. 2009 Dec 1;27(34):5794–9.32. Heng DY, Xie W, Regan MM, Harshman LC, Bjarnason GA, Vaishampayan UN, et al. External validation and comparison with other models of the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model: a population-based study. Lancet Oncol. 2013 Feb;14(2):141–8.33. Ged Y, Sanchez A, Patil S, Knezevic A, Stein E, Petruzella S, et al. Associations between Pretreatment Body Composition Features and Clinical Outcomes among Patients with Metastatic Clear Cell Renal Cell Carcinoma Treated with Immune Checkpoint Blockade. Clinical Cancer Research. 2022 Dec 1;28(23):5180–9.34. Shah, N. J., Sura, S. D., Shinde, R., Shi, J., Singhal, P. K., Robert, N. J., Vogelzang, N. J., Perini, R. F., & Motzer, R. J. (2023). Real-world treatment patterns and clinical outcomes for metastatic renal cell carcinoma in the current treatment era. European Urology Open Science, 49, 110–118. https://doi.org/10.1016/j.euros.2022.12.015spaORIGINALTrabajo de grado.pdfTrabajo de grado.pdfapplication/pdf462843https://repositorio.unbosque.edu.co/bitstreams/52a6fbf3-cd88-42bb-a25b-e89333949cfe/download88db8d7b6bf1949d090e6b8104432c8cMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-82000https://repositorio.unbosque.edu.co/bitstreams/8f6cf55f-152d-4564-b802-70f49118bf11/download17cc15b951e7cc6b3728a574117320f9MD55Carta de autorizacion.pdfapplication/pdf221282https://repositorio.unbosque.edu.co/bitstreams/ba2b826c-b424-45a4-a1aa-8ec10baa47de/download3da9eaa05a851300241015b58cdedd5bMD57Anexo 1 Acta de aprobacion.pdfapplication/pdf179287https://repositorio.unbosque.edu.co/bitstreams/86399330-a527-4d03-94f7-41d634c2b6d9/download9bf4ece461e1b6e40fb1386a80bcdc07MD58CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8899https://repositorio.unbosque.edu.co/bitstreams/79ef12bf-9dcb-493a-9530-acbb93394890/download3b6ce8e9e36c89875e8cf39962fe8920MD56TEXTTrabajo de grado.pdf.txtTrabajo de grado.pdf.txtExtracted texttext/plain72777https://repositorio.unbosque.edu.co/bitstreams/5cf1e790-2e1b-4e17-8730-40997ad556ac/download2304d3da80c0c136fe689981b668832fMD59THUMBNAILTrabajo de grado.pdf.jpgTrabajo de grado.pdf.jpgGenerated Thumbnailimage/jpeg3136https://repositorio.unbosque.edu.co/bitstreams/ca898f65-ccb1-4651-8831-34b5849f3814/download9377f9f46fa3d2fa1118ab01c6d2e104MD51020.500.12495/13928oai:repositorio.unbosque.edu.co:20.500.12495/139282025-02-12 03:02:09.875http://creativecommons.org/licenses/by-nc-nd/4.0/Attribution-NonCommercial-NoDerivatives 4.0 Internacionalopen.accesshttps://repositorio.unbosque.edu.coRepositorio Institucional Universidad El Bosquebibliotecas@biteca.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

Publicaciones similares