Evidence map›Paper›PMID 40613546›Full record

ArticleInternational journal of urology : official journal of the Japanese Urological Association2025

Impact of Impaired Renal Function on the Efficacy and Safety of Second-Line Tyrosine Kinase Inhibitor Therapy After First-Line Immuno-Oncology Combination Therapy in Metastatic Renal Cell Carcinoma: A Japanese Multicenter Retrospective Study.

Naoki Fujita, Yuto Matsushita, Takahiro Kojima, Yukari Bando, Takahiro Osawa, Tomokazu Sazuka, Keisuke Goto, Kazuyuki Numakura, Kazutoshi Yamana, Shuya Kandori and 11 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of urology : official journal of the Japanese Urological Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Naoki FujitaDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.ORCID https://orcid.org/0000-0001-8284-9582
Yuto MatsushitaDepartment of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan.ORCID https://orcid.org/0000-0002-8159-9793
Takahiro KojimaDepartment of Urology, Aichi Cancer Center, Nagoya, Japan.
Yukari BandoDivision of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.ORCID https://orcid.org/0000-0001-7736-1216
Takahiro OsawaDepartment of Urology, Hokkaido University Hospital, Sapporo, Japan.ORCID https://orcid.org/0000-0003-4444-7958
Tomokazu SazukaDepartment of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.ORCID https://orcid.org/0000-0002-8902-7853
Keisuke GotoDepartment of Urology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.ORCID https://orcid.org/0000-0002-3580-1401
Kazuyuki NumakuraDepartment of Urology, Akita University Graduate School of Medicine, Akita, Japan.
Kazutoshi YamanaDepartment of Urology and Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Shuya KandoriDepartment of Urology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.ORCID https://orcid.org/0000-0003-4621-8470
Yoshihide KawasakiDepartment of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan.ORCID https://orcid.org/0000-0001-6425-3574
Takuma KatoDepartment of Urology, Faculty of Medicine, Kagawa University, Takamatsu, Kagawa, Japan.ORCID https://orcid.org/0000-0003-2047-496X
Makito MiyakeDepartment of Urology, Nara Medical University, Kashihara, Japan.ORCID https://orcid.org/0000-0001-9503-7356
Kazutoshi FujitaDepartment of Urology, Kindai University Faculty of Medicine, Osaka, Japan.
Kosuke UedaDepartment of Urology, Kurume University School of Medicine, Kurume, Japan.ORCID https://orcid.org/0000-0002-8154-6616
Hajime TanakaDepartment of Urology, Institute of Science Tokyo, Tokyo, Japan.ORCID https://orcid.org/0000-0003-3632-2901
Ryotaro TomidaDepartment of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
Hiroshi KitamuraDepartment of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan.
Hideaki MiyakeDivision of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
Shingo HakakeyamaDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.ORCID https://orcid.org/0000-0002-0026-4079
Japanese Urological Oncology Group

Funding

Japan Society for the Promotion of Science 19K18603
6 · The paper itself

Abstract

objectivesTo evaluate the effects of renal impairment at the time of second-line tyrosine kinase inhibitor (TKI) therapy initiation and rapid renal function decline during first-line immuno-oncology (IO) combination therapy on metastatic renal cell carcinoma (mRCC) patients treated with second-line TKIs.

methodsThis multicenter retrospective study included 243 mRCC patients treated with first-line IO combination therapy, followed by second-line TKI therapy. Patients were divided into three groups using the estimated glomerular filtration rate (eGFR; mL/min/1.73 m

resultsThe incidence rates of any grade and grade ≥ 3 adverse events were not significantly different among the three groups. Univariable analyses indicated that eGFR slope was not significantly associated with PFS or OS. Multivariable analyses suggested that moderate (30 ≤ eGFR < 60 mL/min/1.73 m

conclusionsTKIs can be safely used as a second-line treatment after first-line IO combination therapy in mRCC patients with renal impairment without sacrificing oncological outcomes, except for in patients with severe renal impairment.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Renal CellKidney NeoplasmsProtein Kinase InhibitorsRenal InsufficiencyAdultAgedAged, 80 and overEast Asian PeopleFemaleGlomerular Filtration RateHumansJapanMaleMiddle AgedProgression-Free SurvivalProtein Kinase InhibitorsTyrosine Kinase Inhibitorschronic kidney diseaseoncological outcomesrenal function declinesafetysecond‐line TKI

Identifiers

PMID40613546
PMCPMC12503203

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.