{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:05:30Z","timestamp":1787065530409,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"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":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Combination therapies incorporating immune checkpoint inhibitors (ICIs) are widely used as first\u2010line treatment for metastatic renal cell carcinoma (mRCC). However, the optimal sequence of subsequent therapies remains unclear. In this study, we investigated the real\u2010world outcomes of nivolumab rechallenge after first\u2010line ICI\u2010based combination therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty\u2010eight consecutive patients with mRCC who received nivolumab monotherapy as third\u2010 or later\u2010line treatment after first\u2010line ICI\u2010based combination therapy were identified from a multicenter database. The best overall response (BOR), progression\u2010free survival (PFS), overall survival (OS), immune\u2010related adverse events (irAEs), and prognostic factors associated with PFS were retrospectively analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age was 68\u2009years. Twenty\u2010two patients (78.6%) had clear cell RCC. Nivolumab was administered as third\u2010, fourth\u2010, and fifth\u2010line therapy in 19 (67.9%), 7 (25.0%), and 2 (7.1%) patients, respectively. The median follow\u2010up period was 6.4\u2009months. The BORs were complete response, partial response, stable disease, and progressive disease in 0, 2 (7.1%), 7 (25.0%), and 19 (67.9%) patients, respectively. The median PFS and OS were 2.2 and 8.8\u2009months, respectively. irAEs occurred in 7 patients (25.0%), including 5 patients (17.9%) with grade 3 irAEs. No grade 4 or higher events were observed. In multivariable analysis, good performance status and a shorter duration of first\u2010line ICI\u2010based combination therapy were associated with improved PFS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nivolumab rechallenge demonstrated modest efficacy in patients with mRCC after first\u2010line ICI\u2010based combination therapy, although a limited subset of patients may derive clinical benefit from this approach. irAEs during nivolumab rechallenge were generally manageable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70559","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T20:24:36Z","timestamp":1782937476000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real\u2010World Outcomes and Prognostic Factors of Immune Checkpoint Inhibitor Rechallenge for Metastatic Renal Cell Carcinoma: A Multicenter Study"],"prefix":"10.1111","volume":"33","author":[{"given":"Shunya","family":"Matsumoto","sequence":"first","affiliation":[{"name":"Department of Urology Institute of Science Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3632-2901","authenticated-orcid":false,"given":"Hajime","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Urology Institute of Science Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8159-9793","authenticated-orcid":false,"given":"Yuto","family":"Matsushita","sequence":"additional","affiliation":[{"name":"Department of Urology Hamamatsu University School of Medicine  Hamamatsu 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Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naotaka","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Toyama  Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7402-6164","authenticated-orcid":false,"given":"Shimpei","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Urology Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7404-0369","authenticated-orcid":false,"given":"Hisanori","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Department of Urology and Andrology Kansai Medical University  Hirakata Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Goto","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironori","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihide","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Department of Urology Tohoku University Graduate School of Medicine  Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Toyama  Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Miyake","sequence":"additional","affiliation":[{"name":"Department of Urology Kobe University Graduate School of Medicine  Kobe 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