Toripalimab plus axitinib versus sunitinib as first-line treatment for advanced renal cell carcinoma: RENOTORCH, a randomized, open-label, phase III study.

BACKGROUND: Immune checkpoint inhibitors in combination with tyrosine kinase inhibitors are standard treatments for advanced clear cell renal cell carcinoma (RCC). This phase III RENOTORCH study compared the efficacy and safety of toripalimab plus axitinib versus sunitinib for the first-line treatment of patients with intermediate-/poor-risk advanced RCC. PATIENTS AND METHODS: Patients with intermediate-/poor-risk unresectable or metastatic RCC were randomized in a ratio of 1 : 1 to receive toripalimab (240 mg intravenously once every 3 weeks) plus axitinib (5 mg orally twice daily) or sunitinib [50 mg orally once daily for 4 weeks (6-week cycle) or 2 weeks (3-week cycle)]. The primary endpoint was progression-free survival (PFS) assessed by an independent review committee (IRC). The secondary endpoints were investigator-assessed PFS, overall response rate (ORR), overall survival (OS), and safety. RESULTS: A total of 421 patients were randomized to receive toripalimab plus axitinib (n = 210) or sunitinib (n = 211). With a median follow-up of 14.6 months, toripalimab plus axitinib significantly reduced the risk of disease progression or death by 35% compared with sunitinib as assessed by an IRC [hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.49-0.86; P = 0.0028]. The median PFS was 18.0 months in the toripalimab-axitinib group, whereas it was 9.8 months in the sunitinib group. The IRC-assessed ORR was significantly higher in the toripalimab-axitinib group compared with the sunitinib group (56.7% versus 30.8%; P < 0.0001). An OS trend favoring toripalimab plus axitinib was also observed (HR 0.61, 95% CI 0.40-0.92). Treatment-related grade ≥3 adverse events occurred in 61.5% of patients in the toripalimab-axitinib group and 58.6% of patients in the sunitinib group. CONCLUSION: In patients with previously untreated intermediate-/poor-risk advanced RCC, toripalimab plus axitinib provided significantly longer PFS and higher ORR than sunitinib and had a manageable safety profile TRIAL REGISTRATION: ClinicalTrials.gov NCT04394975.

[Quantitative study of airborne fungi at three functional sections of Chengdu city].

Airborne fungi are considered as one of the important causes of allergies throughout the world. The climatic conditions of Chengdu are suitable for the breeding of molds. We conducted monthly a quantitative investigation of the airborne fungi at three functional sections of Chengdu city from January to December, 1987. The results indicated that the concentration of fungal spores in the air was high through the year. The range of the concentrations of the airborne fungi was 870.37-7592.59 spores/m3, with two peaks in April and October. The first six dominant airborne fungi were yeast, Cladosporium, Penicillium, Aspergillus, Aureobasidium and Non-sporulating. Of Aspergillus flavus strains detected by fluorescence of agar medium under ultraviolet light 33.49% were aflatoxin-producing. The data show that the climatic and environment factors can affect the spread of airborne fungal spores in the air. The results of previous studies and present surveys are compared and the offence of airborne fungi and the significance of this survey are also discussed in this paper.

[A serological survey of Legionnaires' disease in domestic fowls and animals in Chengdu area].

A serological survey of antibodies against Legionella pneumophila (Lp) serotypes in Chengdu area by microagglutination test showed that there were high levels of antibodies against serotypes Lp1 and Lp6 in healthy domestic fowls and animals (rabbits, pigs, chickens, ducks and geese). In rabbits, antibodies against serotypes Lp1-Lp6 were determined, showing positive rates (titer greater than or equal to 1:16) ranging 6.3-23.8%. Among them only the serotype Lp3 did not show any positive one. The highest positive rate was observed in pigs' anti-Lp6 (89.8%), significantly higher than those reported in America, Denmark and Nanjing, China. The results suggested that recessive infections of Legionnaires' Disease Bacterium might occur in domestic fowls and animals. So the epidemiological surveillance of Legionnaires' disease in animals, as well as in environment (water and soil) is of importance for the prevention in man.