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rekeningnummer RABO 37.29.31.138 t.n.v. Stichting Gezondheid Actueel in Terneuzen.
Onze IBANcode is NL79 RABO 0372 9311 38

17 mei 2019: Zie ook dit artikel:

https://kanker-actueel.nl/immuuntherapie-met-rocapuldencel-t-ags-003-een-vorm-van-dendritische-celtherapie-met-individuele-t-cel-stimulatie-geeft-uitstekende-resultaten-bij-nieuwe-patienten-met-uitgezaaide-nierkanker.html

Zie verder ook in gerelateerde artikelen voor andere publicaties over immuuntherapie bij nierkanker.

17 mei 2019: Bron: The Lancet 9 mei 2019

Immuuntherapie met het anti-PD medicijn Atezolizumab plus Avestin - bevacizumab geeft betere mediane progressievrije overleving (11.2 vs 7.7 maanden; HR, 0.74) dan sunitinib bij patienten die bij de eerste diagnose al uitgezaaide nierkanker hebben.
De overall overleving was in de groep met patienten met PD1-L1 positieve expressie beter maar heeft nog geen statistische significantie bereikt.  

Mediane follow-up was 15 maanden voor de primaire doel om progressievrije ziekte te bereiken en 24 maanden voor de overall overleving analyse. 

Dat blijkt uit een gerandomiseerde  fase III studie (IMmotion151 studie) bij totaal 915 patienten uit 151 ziekenhuizen.

De onderzoekers schrijven wel dat de studie nog doorloopt om ook de resultaten op langere termijn en overall overleving vast te stellen maar inmiddels is wel al statistische significantie bij de progressievrije ziekte bereikt zoals ze dat zeggen.

  • The combination of atezolizumab plus bevacizumab was associated with longer median progression-free survival (11.2 vs 7.7 months; HR, 0.74).
  • Longer-term follow-up is needed to determine whether a survival difference exists between the treatment groups.

Zie studieprotocol onder: ClinicalTrials.gov, number NCT02420821

Het volledige studierapport: 

Atezolizumab plus bevacizumab versus sunitinib in patients with previously untreated metastatic renal cell carcinoma (IMmotion151): a multicentre, open-label, phase 3, randomised controlled trial  is tegen betaling in te zien.

Hier het abstract van de studie die ik niet verder vertaal want lijkt me duidelijk genoeg of gebruik anders google translate rechtsboven dit artikel.

The Lancet: Published:May 09, 2019DOI:https://doi.org/10.1016/S0140-6736(19)30723-8

Atezolizumab plus bevacizumab versus sunitinib in patients with previously untreated metastatic renal cell carcinoma (IMmotion151): a multicentre, open-label, phase 3, randomised controlled trial

Summary

Background

A phase 2 trial showed improved progression-free survival for atezolizumab plus bevacizumab versus sunitinib in patients with metastatic renal cell carcinoma who express programmed death-ligand 1 (PD-L1). Here, we report results of IMmotion151, a phase 3 trial comparing atezolizumab plus bevacizumab versus sunitinib in first-line metastatic renal cell carcinoma.

Methods

In this multicentre, open-label, phase 3, randomised controlled trial, patients with a component of clear cell or sarcomatoid histology and who were previously untreated, were recruited from 152 academic medical centres and community oncology practices in 21 countries, mainly in Europe, North America, and the Asia-Pacific region, and were randomly assigned 1:1 to either atezolizumab 1200 mg plus bevacizumab 15 mg/kg intravenously once every 3 weeks or sunitinib 50 mg orally once daily for 4 weeks on, 2 weeks off. A permuted-block randomisation (block size of 4) was applied to obtain a balanced assignment to each treatment group with respect to the stratification factors. Study investigators and participants were not masked to treatment allocation. Patients, investigators, independent radiology committee members, and the sponsor were masked to PD-L1 expression status. Co-primary endpoints were investigator-assessed progression-free survival in the PD-L1 positive population and overall survival in the intention-to-treat (ITT) population. This trial is registered with ClinicalTrials.gov, number NCT02420821.

Findings

Of 915 patients enrolled between May 20, 2015, and Oct 12, 2016, 454 were randomly assigned to the atezolizumab plus bevacizumab group and 461 to the sunitinib group. 362 (40%) of 915 patients had PD-L1 positive disease. Median follow-up was 15 months at the primary progression-free survival analysis and 24 months at the overall survival interim analysis. In the PD-L1 positive population, the median progression-free survival was 11·2 months in the atezolizumab plus bevacizumab group versus 7·7 months in the sunitinib group (hazard ratio 0·74 [95% CI 0·57–0·96]; p=0·0217). In the ITT population, median overall survival had an HR of 0·93 (0·76–1·14) and the results did not cross the significance boundary at the interim analysis. 182 (40%) of 451 patients in the atezolizumab plus bevacizumab group and 240 (54%) of 446 patients in the sunitinib group had treatment-related grade 3–4 adverse events: 24 (5%) in the atezolizumab plus bevacizumab group and 37 (8%) in the sunitinib group had treatment-related all-grade adverse events, which led to treatment-regimen discontinuation.

Interpretation

Atezolizumab plus bevacizumab prolonged progression-free survival versus sunitinib in patients with metastatic renal cell carcinoma and showed a favourable safety profile. Longer-term follow-up is necessary to establish whether a survival benefit will emerge. These study results support atezolizumab plus bevacizumab as a first-line treatment option for selected patients with advanced renal cell carcinoma.

Funding

F Hoffmann–La Roche Ltd and Genentech Inc.

 


Plaats een reactie ...

1 Reactie op "Immuuntherapie met Atezolizumab plus Avestin - bevacizumab geeft betere progressievrije ziekte en overall overleving dan sunitinib bij patienten met gevorderde uitgezaaide nierkanker"

  • Yvonne van der Plas :
    Ik heb sunitinib eerste lijn behandeling.
    Kom ik dan nog in aanmerking voor deze therapie?
    Vriendelijke groeten Yvonne van der Plas.

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