PD40-08 DOES THE TIME BEFORE STARTING FIRST-LINE TREATMENT INFLUENCES THE SURVIVAL OF PATIENTS WITH METASTATIC RENAL CELL CANCER IN FAVORABLE-RISK GROUPS?

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) II (PD40)1 Sep 2021PD40-08 DOES THE TIME BEFORE STARTING FIRST-LINE TREATMENT INFLUENCES THE SURVIVAL OF PATIENTS WITH METASTATIC RENAL CELL CANCER IN FAVORABLE-RISK GROUPS? Cyrielle Rolley, Marie Cruz, François-Xavier Nouhaud, Arnaud Villers, Karim Bensalah, Franck Bruyere, Solene Ricard, Jean-Christophe Bernhard, and Pierre Bigot Cyrielle RolleyCyrielle Rolley More articles by this author , Marie CruzMarie Cruz More articles by this author , François-Xavier NouhaudFrançois-Xavier Nouhaud More articles by this author , Arnaud VillersArnaud Villers More articles by this author , Karim BensalahKarim Bensalah More articles by this author , Franck BruyereFranck Bruyere More articles by this author , Solene RicardSolene Ricard More articles by this author , Jean-Christophe BernhardJean-Christophe Bernhard More articles by this author , and Pierre BigotPierre Bigot More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002050.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: RCC Data Base Consortium (IMDC). Patients in the favorable IMDC group (F-MRC) have a slow metastatic course and seem to have a poorer response to immunotherapy. Delayed treatment could be a good option in this specific population. A deferred treatment allows: to preserve the quality of life, to avoid side effects, to limit costs, and to delay the occurrence of resistance to treatments. The main objective of this study was to determine if the time before starting first-line treatment influences the survival of patients in the F-MRC group. METHODS: We performed a multicenter national study involving the French Network for Research on Kidney Cancer (UroCCR (NCT03293563)). We included treatment naive F-MRC patients. The initiation of first line treatment was left to the discretion of each physician after a multidisciplinary uro-oncology committee discussion about the treatment strategy. We compared the overall survival between patients with immediate medical treatment (IMT) (started less than 3 months after metastatic diagnosis) and delayed medical treatment (DMT). RESULTS: We included 90 patients treated between 2000 and 2018. The median age was 63 (32-83) years. The median time before occurrence of metastases was 28 (11-137) months. 78 (86.7%) patients had a clear renal cell carcinoma and 29 (32%) patients had a unique site of metastases. IMT was given in 26 (28.8%) patients. Local treatment of metastasis (LTM) was performed in 44 (48%) patients with: 32 (36%) metastasectomy, 8 (8.9%) ablative therapy and 14 (15.9%) radiotherapy. After a median follow-up of 59.5 (11 - 189) months after metastasis diagnosis: 19 (21.1%) patients died. Among patients with DMT, only 26 (40.6%) received a medical treatment with a median time before treatment of 19 (4-77) months. The two groups (IMT vs DMT) were comparable for follow-up, age, sarcomatoid feature, number of metastatic sites and ECOG performans status. Patients with DMT had more LTM (57% vs 27%, p=0.01). Median overall survival was 78 months in the IMT group and 135 months in the DMT group (p=0.067). In multivariable analysis LTM was the only prognostic factor for survival (HR: 0.32; p=0.032). CONCLUSIONS: Patients with F-MRC can safely undergo DMT. LTM positively impacted survival in this population and should be considered whenever possible. Prospective trial with a larger population is needed to confirm these outcomes. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e677-e677 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cyrielle Rolley More articles by this author Marie Cruz More articles by this author François-Xavier Nouhaud More articles by this author Arnaud Villers More articles by this author Karim Bensalah More articles by this author Franck Bruyere More articles by this author Solene Ricard More articles by this author Jean-Christophe Bernhard More articles by this author Pierre Bigot More articles by this author Expand All Advertisement Loading ...