免疫检查点抑制剂（ICI）的出现给免疫原性肿瘤的治疗带来了重大转变。 2015年11月23日，美国食品药品监督管理局批准Nivolumab用于治疗转移性肾细胞癌（RCC）。我们的目的是评估纳武单抗获批后，人群水平上转移性肾细胞癌患者生存率的潜在变化。我们使用的数据来自最新版本的监测、流行病学和最终结果 (SEER) 数据库，该数据库包含高达2020年。我们纳入了2011年至2020年期间被诊断为“远处”肾细胞癌的年龄≥20岁的患者。基于纳武单抗的批准，2011年至2020年期间进一步分为2011年至2015年（ICI前时代） ）和 2016-2020 年（ICI 时代）。ICI 之前时代的中位总生存期 (OS) 为 8 个月，而 ICI 时代为 11 个月（对数秩检验，χ2 = 102.53，p < 0.001）。与 ICI 之前诊断的患者相比，ICI 时代诊断为转移性肾细胞癌的患者死亡风险显着降低 [Cox 比例风险比为 0.77，95% CI (0.74-0.80)]。此外，与 75 岁或以上的患者相比，75 岁以下的患者死亡风险较低。接受化疗（全身治疗）、放疗或手术的患者的死亡风险显着降低。脑、骨、肝或肺转移的个体的死亡风险明显高于未转移到这些部位的个体。婚姻状况也发挥了作用，因为与诊断时离婚、分居或丧偶的人相比，已婚者的死亡风险显着降低。此外，收入水平影响生存，家庭年收入中位数超过 75,000 美元的患者与收入在 50,000 美元至 74,000 美元之间的患者相比，死亡风险显着降低。非西班牙裔黑人和非西班牙裔白人之间的生存率没有显着差异。免疫检查点抑制剂的出现使被诊断患有转移性肾细胞癌的个体的中位总生存期显着改善。版权所有 © 2024 Elsevier Ltd 。 版权所有。

The advent of immune checkpoint inhibitors (ICI) has brought about a significant transformation in the treatment of immunogenic tumors. On November 23, 2015, the United States Food and Drug Administration approved Nivolumab to treat metastatic renal cell carcinoma (RCC). We aimed to assess potential changes in the survival rates of patients with metastatic RCC at a population level after the approval of Nivolumab.We used data from the latest version of the Surveillance, Epidemiology, and End Results (SEER) database which encompasses data up to the year 2020. We included patients with age ≥ 20 years who were diagnosed with 'distant' RCC from 2011 through 2020. Based on the approval of Nivolumab, the period from 2011 to 2020 was further grouped into 2011-2015 (pre-ICI era) and 2016-2020 (ICI era).The median overall survival (OS) was 8 months in the pre-ICI era compared to 11 months in the ICI era (log-rank test, χ2 = 102.53, p < 0.001). Patients diagnosed with metastatic RCC in the ICI era had a significantly lower risk of dying [Cox proportional Hazard Ratio of 0.77, 95 % CI (0.74-0.80)] compared to patients diagnosed in the pre-ICI era. Additionally, patients under the age of 75 had a lower risk of death compared to those aged 75 years or older. Patients who received chemotherapy (systemic therapy), radiotherapy, or surgery faced a significantly lower risk of mortality. Individuals with metastasis to the brain, bone, liver, or lung had a significantly higher risk of death than those without metastasis to these locations. Marital status also played a role, as married individuals had a significantly lower risk of death compared to those who were divorced, separated, or widowed at the time of diagnosis. Furthermore, income level influenced survival, with patients earning a median annual household income of more than USD 75,000 exhibiting a significantly lower risk of mortality compared to those earning between USD 50,000 and USD 74,000. There was no significant difference in survival observed between non-Hispanic blacks and non-Hispanic whites.The advent of immune checkpoint inhibitors has led to a substantial improvement in the median overall survival of individuals diagnosed with metastatic renal cell carcinoma.Copyright © 2024 Elsevier Ltd. All rights reserved.