PCN19 - Comparison Of Treatment Duration Among Targeted Agents In Renal Cell Carcinoma (Rcc)

Abstract

Conducting comparative effectiveness research among multiple classes of treatments may inform optimal treatment based on the real-world effectiveness. We conducted a retrospective analysis comparing the duration of six leading treatment options in renal cell carcinoma stratified by line of therapy. Using claims data (MORE2 Registry), patients with renal cell carcinoma who started and completed at least one line of treatment during the study period (January 2012 to February 2014) were identified by ICD9 code 189.0. Line of therapy (LOT) was assigned based on the patient’s available treatment history. Analysis was stratified by LOT. Univariate analysis of variance was performed to compare mean durations among treatment options, LOT, and therapeutic class. Multivariate analysis controlling for demographic and treatment characteristics will be presented in the poster. Patients received 1240 complete lines of therapy. Mean duration of treatment by line of therapy was as follows: 1st LOT: 4.0 mo (n=599); 2nd LOT: 3.2 mo (n=357); 3rd LOT 3.1 mo (n=284). There was statistically significant difference in mean duration of therapy between the groups of patients by second line regimen (p=0.003). Within the second line patient group the tyrosine kinase inhibitor (TKI) treated patients had greater duration compared to the mammalian target of rapamycin (mTOR) treated patients (3.5 mo vs 2.6 mo, p-value=0.006). However no difference in duration was observed among first (p=0.7239) and third line regimens (p=.0.6476). In this study there was statistically significant difference in duration among leading systemic agents used for second-line treatment of RCC where patients were shown to remain on TKI treatment longer than mTOR treatment. Future research should determine if toxicity and costs influence duration in this therapeutic area.