{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T07:19:28Z","timestamp":1773818368554,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitor (ICI)\u2010based combination therapies are first\u2010line treatments for locally advanced or metastatic renal cell carcinoma (mRCC). However, second\u2010line treatment efficacy remains uncertain due to limited large randomized trials. This study evaluated real\u2010world oncological outcomes after second\u2010line treatments in patients who received combination ICIs as first\u2010line treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 467 patients who received ICI combination therapy as first\u2010line treatment for mRCC between January 2018 and January 2024, those who received cabozantinib (Cabo) or axitinib (Axi) as second\u2010line treatment were included in this study. The patient characteristics at the initiation of second\u2010line treatment, progression\u2010free survival (PFS), and overall survival (OS) were compared between the two groups. Prognostic factors associated with OS after the initiation of second\u2010line treatment were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The Cabo and Axi groups included 87 and 45 patients, respectively. Median OS and PFS after the initiation of secondary treatment were 32 and 9\u2009months in the Cabo group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.269), and 33 and 12\u2009months in the Axi group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.399). Multivariable analysis identified serum C\u2010reactive protein (CRP)\u2009\u2265\u20090.6\u2009mg\/dL and estimated glomerular filtration rate (eGFR)\u2009&lt;\u200940\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      at the start of secondary treatment as independent predictors of OS. Stratification by these factors revealed a significant OS difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Oncological outcomes after the initiation of secondary treatment did not differ significantly between the Cabo and Axi groups. An eGFR &lt;\u200940\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      and CRP \u2265\u20090.6\u2009mg\/dL at the start of Cabo or Axi treatment were independent OS predictors after secondary treatment.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70138","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T04:59:33Z","timestamp":1748408373000},"page":"1225-1233","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Estimated Glomerular Filtration Rate and Serum C\u2010Reactive Protein Level to Overall Survival After Second\u2010Line Targeted Therapy Following Immuno\u2010Oncology Combination Therapy for Advanced Renal Cell Carcinoma"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2589-1722","authenticated-orcid":false,"given":"Keita","family":"Nakane","sequence":"first","affiliation":[{"name":"Department of Urology Gifu University Graduate School of Medicine  Gifu Gifu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5186-7139","authenticated-orcid":false,"given":"Hiromitsu","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Urology Hamamatsu University School of Medicine  Hamamatsu Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7638-6048","authenticated-orcid":false,"given":"Taku","family":"Naiki","sequence":"additional","affiliation":[{"name":"Department of Nephro\u2010Urology, Graduate School of Medical Sciences Nagoya City University  Nagoya Aichi 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