Real-world comparative outcomes of first-line immune combinations (ICI-ICI vs ICI-TKI) in metastatic renal cell carcinoma with sarcomatoid features.

@article{rebuzzi2026realworld,
  title = {{Real-world comparative outcomes of first-line immune combinations (ICI-ICI vs ICI-TKI) in metastatic renal cell carcinoma with sarcomatoid features.}},
  author = {Sara Elena Rebuzzi and Fabrizio Di Costanzo and Roberto Filippi and Pasquale Rescigno and Giuseppe Fornarini and Alessio Signori and Cristina Masini and Roberto Iacovelli and Martina Fanelli and Alberto Dalla Volta and Marilena Di Napoli and Giandomenico Roviello and Annalisa Guida and Cristian Lolli and Claudia Caserta and Rossana Berardi and Mariella Sorarù and Laura Lombardo and Francesco Pierantoni and Elena Verzoni and Alessia Mennitto and Sarah Scagliarini and Marcello Tucci and Maria Giuseppa Vitale and Carlo Messina and Lucia Bonomi and Luca Tondulli and Filippo Maria Deppieri and Francesca La Russa and Luigi Formisano and Cinzia Ortega and Brigida Anna Maiorano and Arianna Dri and Silvia Zai and Emilia Cocorocchio and Michele De Tursi and Emanuela Fantinel and Vincenza Conteduca and Cecilia Nasso and Camilla Sansi and Franco Nolè and Giulia Zago and Enrico Bronte and Giovanni Bozza and Francesca Bertolotti and Noemi Montobbio and Giuseppe Luigi Banna and Sebastiano Buti and Davide Bimbatti},
  journal = {Oncoimmunology},
  year = {2026},
  month = oct,
  doi = {10.1080/2162402x.2026.2751848},
  url = {https://europepmc.org/article/MED/42912018},
  note = {CC BY-NC},
}

TY  - JOUR
TI  - Real-world comparative outcomes of first-line immune combinations (ICI-ICI vs ICI-TKI) in metastatic renal cell carcinoma with sarcomatoid features.
AU  - Sara Elena Rebuzzi
AU  - Fabrizio Di Costanzo
AU  - Roberto Filippi
AU  - Pasquale Rescigno
AU  - Giuseppe Fornarini
AU  - Alessio Signori
AU  - Cristina Masini
AU  - Roberto Iacovelli
AU  - Martina Fanelli
AU  - Alberto Dalla Volta
AU  - Marilena Di Napoli
AU  - Giandomenico Roviello
AU  - Annalisa Guida
AU  - Cristian Lolli
AU  - Claudia Caserta
AU  - Rossana Berardi
AU  - Mariella Sorarù
AU  - Laura Lombardo
AU  - Francesco Pierantoni
AU  - Elena Verzoni
AU  - Alessia Mennitto
AU  - Sarah Scagliarini
AU  - Marcello Tucci
AU  - Maria Giuseppa Vitale
AU  - Carlo Messina
AU  - Lucia Bonomi
AU  - Luca Tondulli
AU  - Filippo Maria Deppieri
AU  - Francesca La Russa
AU  - Luigi Formisano
AU  - Cinzia Ortega
AU  - Brigida Anna Maiorano
AU  - Arianna Dri
AU  - Silvia Zai
AU  - Emilia Cocorocchio
AU  - Michele De Tursi
AU  - Emanuela Fantinel
AU  - Vincenza Conteduca
AU  - Cecilia Nasso
AU  - Camilla Sansi
AU  - Franco Nolè
AU  - Giulia Zago
AU  - Enrico Bronte
AU  - Giovanni Bozza
AU  - Francesca Bertolotti
AU  - Noemi Montobbio
AU  - Giuseppe Luigi Banna
AU  - Sebastiano Buti
AU  - Davide Bimbatti
PY  - 2026
DA  - 2026/10/22
JO  - Oncoimmunology
DO  - 10.1080/2162402x.2026.2751848
UR  - https://europepmc.org/article/MED/42912018
AB  - Introduction  Although first-line immune-based combinations have reshaped the management of metastatic renal cell carcinoma (mRCC), relevant unmet clinical needs remain. Sarcomatoid feature is a negative prognostic factor that confers sensitivity to immunotherapy, yet the optimal ICI combination in this subgroup is still unclear.Methods  The Meet-URO 33 is an Italian multicenter retrospective/prospective observational study enrolling patients with mRCC receiving first-line systemic therapy in routine clinical practice. In the present sub-analysis, objective response and survival outcomes were compared between ICI-ICI and ICI-TKI regimens in patients with documented sarcomatoid differentiation and IMDC intermediate-/poor-risk disease.Results  Among 1695 patients enrolled from 58 centers, 180 (10.6%) had sRCC and among them, 107 (58.2%) were intermediate-risk and 56 (30.4%) were poor-risk. With a median follow-up of 21.8 months, in the I/P-sRCC population with available data (n = 155), univariable analysis showed longer overall survival (OS) with ICI-ICI compared to ICI-TKI (HR 0.58, p = 0.04). However, in propensity score-weighted analyses, point estimates slightly favored ICI-ICI, but no statistically significant differences were observed for OS, PFS, or ORR.Conclusions  In this real-world analysis comparing ICI-ICI and ICI-TKI in sarcomatoid mRCC, propensity score-weighted models showed no statistically significant differences between treatment combinations on clinical outcomes. These findings highlight the relevance of baseline disease and patients characteristics in shaping treatment outcomes and confirm the effectiveness of ICI-containing combinations in the treatment of sarcomatoid mRCC.
SN  - 2162-4011
SN  - 2162-402X
ER  -