{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:21:46Z","timestamp":1783488106469,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"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":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Sarcomatoid renal cell carcinoma (sRCC) is an aggressive histological variant associated with a poor prognosis. While immune checkpoint inhibitor (ICI)\u2010based combinations have become the standard of care, the optimal first\u2010line regimen, specifically dual immunotherapy (IO\u2010IO) vs. IO plus tyrosine kinase inhibitor (IO\u2010TKI), remains controversial. We herein examined the real\u2010world clinical outcomes of Japanese patients with sRCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective multicenter study on 46 patients with advanced or metastatic sRCC receiving first\u2010line ICI\u2010based combination therapy between January 2018 and December 2024 (IO\u2010IO:\n                      <jats:italic>n<\/jats:italic>\n                      =\u200918; IO\u2010TKI:\n                      <jats:italic>n<\/jats:italic>\n                      =\u200928). In a comparative survival analysis, three favorable\u2010risk patients in the IO\u2010TKI group were excluded to align risk profiles, focusing on intermediate\/poor\u2010risk groups (\n                      <jats:italic>n<\/jats:italic>\n                      =\u200943). The primary endpoint was overall survival (OS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the entire cohort (\n                      <jats:italic>n<\/jats:italic>\n                      =\u200946), the objective response rate was numerically higher in the IO\u2010TKI group (64.3%) than in the IO\u2010IO group (50.0%) (\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.37). In the comparative analysis of intermediate\/poor\u2010risk patients (\n                      <jats:italic>n<\/jats:italic>\n                      =\u200943), progression\u2010free survival (PFS) was slightly longer (\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.071), and OS was significantly longer (\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.016) in the IO\u2010TKI group than in the IO\u2010IO group. A multivariable analysis adjusted for IMDC risk categories showed favorable survival with the IO\u2010TKI regimen (HR 0.37,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.061).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The present study indicates that first\u2010line IO\u2010TKI combination therapy represents a promising treatment option with a potential survival advantage over IO\u2010IO therapy for Japanese patients with sRCC. However, due to the retrospective design and small sample size, reliably determining the comparative efficacy of these regimens remains challenging, and further validation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70494","type":"journal-article","created":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T04:43:56Z","timestamp":1778388236000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Efficacy of First\u2010Line Immune Checkpoint Inhibitor\u2010Based Combination Therapies in Patients With Sarcomatoid Renal Cell Carcinoma: A Japanese Multicenter Cohort Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4305-7328","authenticated-orcid":false,"given":"Keita","family":"Tamura","sequence":"first","affiliation":[{"name":"Department of Urology Hamamatsu University School of Medicine  Shizuoka 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School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Morinaka","sequence":"additional","affiliation":[{"name":"Department of Urology Kawasaki Medical School  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Bekku","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Urology Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9902-1694","authenticated-orcid":false,"given":"Takuhisa","family":"Nukaya","sequence":"additional","affiliation":[{"name":"Department of Urology Fujita\u2010Health University School of Medicine  Toyoake Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9045-5484","authenticated-orcid":false,"given":"Ryoichi","family":"Maenosono","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumasa","family":"Komura","sequence":"additional","affiliation":[{"name":"Department of Urology Kawasaki Medical School  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3172-2482","authenticated-orcid":false,"given":"Motoo","family":"Araki","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences  Okayama 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