Preliminary study on the efficacy of pazopanib combined with toripalimab as first-line therapy for metastatic renal cell carcinoma: Real-world data from a single center.

The present study aimed to explore the clinical efficacy and safety of pazopanib combined with toripalimab as first-line therapy for metastatic renal cell carcinoma (mRCC), providing a reference for clinical decision-making. In the present study, clinical data from 22 patients with mRCC who received pazopanib combined with toripalimab treatment at Shanxi Province Cancer Hospital (Taiyuan, China) were retrospectively collected. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and drug safety were analyzed. Among the 22 patients (17 men and 5 women), the median age was 63.5 years. In terms of pathological classification, 19 patients (86.4%) had clear cell RCC. The organs with metastasis mainly included the lungs, lymph nodes, bones, liver and brain. According to the International Metastatic Renal Cell Carcinoma Database Consortium risk classification, 13.6% (3 patients) were classified as favorable-risk, 77.3% (17 patients) were classified as intermediate-risk and 9.1% (2 patients) were classified as poor-risk. A total of 6 patients (27.3%) discontinued treatment due to adverse events (AEs), which included hypertension, proteinuria, elevated transaminases and hypothyroidism. The median follow-up time was 14 months (range, 3-24 months). The overall ORR was 36.36% and the DCR was 77.27%. The median PFS time was 17.1 months (range, 5.9-22.6), while the median OS was not reached. Common AEs included fatigue (27.27%), nausea/vomiting (18.18%), diarrhea (31.82%), hypertension (31.82%), proteinuria (22.73%), elevated transaminases (63.64%), hypothyroidism (18.18%), hand-foot skin reaction (22.73%), rash (9.09%) and leukopenia (13.64%). In conclusion, in the present small, single-center, retrospective real-world study, pazopanib combined with toripalimab as first-line therapy for mRCC showed preliminary signs of efficacy with manageable AEs. These real-world observations suggested that the combination may be feasible and warrants further prospective investigation; however, no clinical recommendation can be made based on the present data. Further prospective randomized controlled trials are needed.