{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T08:01:20Z","timestamp":1780473680308,"version":"3.54.1"},"reference-count":28,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Immune checkpoint inhibitor\u2013tyrosine kinase inhibitor combinations represent a standard first-line option for metastatic renal cell carcinoma (mRCC). However, patients enrolled in pivotal trials often differ from those treated in routine practice. We report real-world outcomes of pembrolizumab plus axitinib within the Campania Oncology Network. Methods: We conducted a multicenter retrospective study including consecutive treatment-na\u00efve mRCC patients who received first-line pembrolizumab plus axitinib between January 2021 and November 2023 across eight regional centers. The primary endpoints were progression-free survival (PFS) and overall survival (OS); secondary endpoints included objective response rate (ORR) and safety. Results: A total of 117 patients were included. IMDC risk was favorable in 19.6%, intermediate\/poor in 65%, and unknown in 15.4%. Median age was 59 years, and 53.8% had ECOG performance status \u2265 1. Clear-cell histology accounted for 87.2% of cases; brain metastases were present in 36%. After a median follow-up of 12.8 months, median PFS was 15.1 months (95% CI 9.6\u2013NR), and median OS was not reached. ORR was 27.3%, with a disease control rate of 79.5%; patients with non-clear-cell histology showed an ORR of 41.7%. Disease progression was the main cause of treatment discontinuation (49%), while adverse events (AEs) led to discontinuation in 6% of cases. Grade \u22653 AEs occurred in 14% of patients. Most toxicities were grade 1\u20132, including diarrhea (23.9%), asthenia (18%), hypothyroidism (12.8%), and hypertension (9.4%). Grade 1\u20132 AEs were significantly more frequent in females compared with males (57.6% vs. 35.7%, p = 0.05). Conclusions: In this consecutive regional cohort, pembrolizumab plus axitinib showed clinically relevant disease control, although ORR was lower than in pivotal trials. Performance status emerged as a key prognostic factor. Real-world data from oncology networks may support personalized first-line treatment decisions in mRCC.<\/jats:p>","DOI":"10.3390\/curroncol33060325","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T17:11:01Z","timestamp":1780333861000},"page":"325","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Analysis of Metastatic Renal Cell Carcinoma Patients Treated with Pembrolizumab Plus Axitinib: Evidence from the Campania Oncology Network"],"prefix":"10.3390","volume":"33","author":[{"given":"Marilena","family":"Di Napoli","sequence":"first","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Coppola","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmine","family":"D\u2019Aniello","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, AORN dei Colli-Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5814-2296","authenticated-orcid":false,"given":"Sarah","family":"Scagliarini","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, AORN \u201cA. Cardarelli\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Buonerba","sequence":"additional","affiliation":[{"name":"Oncology Unit, \u201cAndrea Tortora\u201d Hospital, 84016 Pagani, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Muto","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, \u201cSan Giuseppe Moscati\u201d Hospital, 83100 Avellino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7294-8595","authenticated-orcid":false,"given":"Luigi","family":"Formisano","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, University of Naples \u201cFederico II\u201d, 80138 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Sabbatino","sequence":"additional","affiliation":[{"name":"Oncology Department, University Hospital \u201cSan Giovanni di Dio e Ruggi d\u2019Aragona\u201d, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Bosso","sequence":"additional","affiliation":[{"name":"Oncology Unit, Ospedale del Mare, 80147 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Rossetti","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4124-2837","authenticated-orcid":false,"given":"Lorenzo","family":"Lobianco","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Tambaro","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Di Costanzo","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Newcastle Upon Tyne NE2 4HH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Rescigno","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Newcastle Upon Tyne NE2 4HH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmela","family":"Pisano","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina Chiara","family":"Cecere","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Passarelli","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jole","family":"Ventriglia","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Calvanese","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rosaria","family":"Lamia","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Perri","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Contieri","sequence":"additional","affiliation":[{"name":"Department of Urology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Franzese","sequence":"additional","affiliation":[{"name":"Department of Urology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8203-9416","authenticated-orcid":false,"given":"Maria Adelina","family":"Simeoni","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unite, Department of Translation Medicine Medical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina Mariarosaria","family":"Giorgio","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 81100 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florinda","family":"Feroce","sequence":"additional","affiliation":[{"name":"Department of Pathology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3295-840X","authenticated-orcid":false,"given":"Salvatore","family":"Stilo","sequence":"additional","affiliation":[{"name":"Interventional Radiology Unit, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Pacifico","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina","family":"Canciello","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro","family":"Pignata","sequence":"additional","affiliation":[{"name":"Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.eururo.2022.08.019","article-title":"Epidemiology of renal cell carcinoma: 2022 update","volume":"82","author":"Bukavina","year":"2022","journal-title":"Eur. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e2443198","DOI":"10.1001\/jamanetworkopen.2024.43198","article-title":"Global disparities of cancer and its projected burden in 2050","volume":"7","author":"Sharma","year":"2024","journal-title":"JAMA Netw. 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