在接受免疫检查点抑制剂治疗的恶性肿瘤患者中，性别对预后的影响一直受到密切讨论，但尤其在晚期肾细胞癌患者中仍不清楚。我们对184名晚期肾细胞癌患者进行了回顾性评估，其中73名接受尼伏单抗和异丙肟联合治疗作为一线治疗，111名接受尼伏单抗作为后线治疗。比较了两性的无进展生存期、总生存期、客观缓解率以及不良事件发生情况。在184名患者中，48名（26%）为女性。女性患者的无进展生存期显著短于男性患者（中位数：3.8个月vs. 8.3个月，P=0.0005），但总生存期（中位数：39.2个月vs. 45.1个月，P=0.283）和客观缓解率（29% vs. 42%，P=0.119）两者之间没有差别。在分析每种治疗方法时，得到了类似的结果；在接受尼伏单抗和异丙肟联合治疗以及尼伏单抗单一治疗的两组患者中，女性患者的无进展生存期显著短于男性患者（P=0.007，P=0.017），但总生存期（P=0.914，P=0.117）和客观缓解率（P=0.109，P=0.465）在两者之间是可比的。此外，在一个由透明细胞肾细胞癌患者组成的更为狭窄的群体中，也观察到女性患者无进展生存期更短（3.8个月vs. 11.0个月，P<0.0001）。这项回顾性研究表明，基于免疫检查点抑制剂的肾细胞癌治疗对女性患者的影响较男性患者轻微。因此，性别可能是决策肾细胞癌全身治疗的重要因素，尽管还需要进一步研究来验证目前的发现。©作者（们）2023年。牛津大学出版社。版权所有。如需授权，请发送电子邮件至journals.permissions@oup.com。

Prognostic impact of sex in patients with malignancies treated with immune checkpoint inhibitors has been intensively discussed but remains unclear, especially in advanced renal cell carcinoma.We retrospectively evaluated a total of 184 patients with advanced renal cell carcinoma treated with either nivolumab plus ipilimumab combined treatment as first-line therapy (n = 73) or nivolumab as later-line therapy (n = 111) at our affiliated institutions. Progression-free survival, overall survival and objective response rate as well as adverse event profile were compared between sexes.Of the total 184 patients, 48 (26%) were female. Female patients had a significantly shorter progression-free survival than male patients (median: 3.8 vs. 8.3 months, P = 0.0005), but overall survival (median: 39.2 vs. 45.1 months, P = 0.283) and objective response rate (29% vs. 42%, P = 0.119) were not different between them. Similar findings were observed when analyzing within each treatment; in both patient groups treated with nivolumab plus ipilimumab combined therapy and nivolumab monotherapy, progression-free survival was significantly shorter in female than in male patients (P = 0.007, P = 0.017), but overall survival (P = 0.914, P = 0.117) and objective response rate (P = 0.109, P = 0.465) were comparable between them. Moreover, in a more restricted cohort consisting of patients with clear-cell renal cell carcinoma, a shorter progression-free survival in female patients was also observed (3.8 vs. 11.0 months, P < 0.0001).This retrospective study showed that immune checkpoint inhibitors-based treatment for renal cell carcinoma exhibited less marked effects in female than in male patients. Thus, sex may be an important factor for decision-making on systemic therapy as renal cell carcinoma treatment, although further studies are required to validate the present findings.© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.