PD40-10 COMPARATIVE EFFECTIVENESS OF FIRST-LINE IMMUNOTHERAPY, TARGETED THERAPY, AND COMBINATION THERAPY FOR METASTATIC CLEAR CELL RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) II (PD40)1 Sep 2021PD40-10 COMPARATIVE EFFECTIVENESS OF FIRST-LINE IMMUNOTHERAPY, TARGETED THERAPY, AND COMBINATION THERAPY FOR METASTATIC CLEAR CELL RENAL CELL CARCINOMA Nicholas Chakiryan, David Jiang, Kyle Gillis, Elizabeth Green, Ali Hajiran, Lee Hugar, Logan Zemp, Jad Chahoud, Jingsong Zhang, Rohit Jain, Wade Sexton, Scott Gilbert, and Brandon Manley Nicholas ChakiryanNicholas Chakiryan More articles by this author , David JiangDavid Jiang More articles by this author , Kyle GillisKyle Gillis More articles by this author , Elizabeth GreenElizabeth Green More articles by this author , Ali HajiranAli Hajiran More articles by this author , Lee HugarLee Hugar More articles by this author , Logan ZempLogan Zemp More articles by this author , Jad ChahoudJad Chahoud More articles by this author , Jingsong ZhangJingsong Zhang More articles by this author , Rohit JainRohit Jain More articles by this author , Wade SextonWade Sexton More articles by this author , Scott GilbertScott Gilbert More articles by this author , and Brandon ManleyBrandon Manley More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002050.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: As compared to targeted therapy (TT), clinical trials have shown an overall survival (OS) benefit for first-line immunotherapy (IT) and combination TT/IT regimens in metastatic clear cell renal cell carcinoma (RCC). Generalizability of these findings in a real-world cohort, outside of a clinical trial setting, is unclear. The primary objective is to assess the effect of first-line TT, IT, and combination TT/IT regimens on OS in a real-world cohort of patients with metastatic clear cell RCC. METHODS: This retrospective propensity-matched study identified patients with metastatic clear cell RCC in the National Cancer Database from 2015-2017 who received either first-line TT, IT, or combination TT/IT and were not treated on a clinical trial protocol. Patients were stratified by first-line systemic treatment. After 1:1:1 nearest-neighbor caliper-matching of propensity scores, survival analyses were conducted using Cox regression and Kaplan-Meier estimates. The primary outcome was OS from the date of diagnosis to death or censoring at last follow-up. RESULTS: The final study population included 5872 patients and the matched cohort included 1437 patients (479 per treatment group). Use of either IT or combination TT/IT increased over the time period studied (14.6%, 17.5%, and 24.3% in 2015, 2016, and 2017, respectively). Patients who were treated with either first-line IT or combination TT/IT had improved OS compared to those who were treated with first-line TT (IT group: HR 0.6 [95% CI, 0.48-0.75], p<.001; combination TT/IT group: HR 0.7 [95% CI, 0.60-0.91], p=.005). No survival difference was seen between the IT and combination TT/IT groups (combination TT/IT: HR 1.24 [95% CI, 0.98-1.56], p=.075). CONCLUSIONS: Patients with metastatic clear cell RCC who received first-line IT or combination TT/IT had improved OS compared to those who received first-line TT. These findings are similar to those identified in recently reported clinical trials, lending confidence to the broader applicability of these findings outside of a clinical trial setting. Source of Funding: NA © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e678-e678 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicholas Chakiryan More articles by this author David Jiang More articles by this author Kyle Gillis More articles by this author Elizabeth Green More articles by this author Ali Hajiran More articles by this author Lee Hugar More articles by this author Logan Zemp More articles by this author Jad Chahoud More articles by this author Jingsong Zhang More articles by this author Rohit Jain More articles by this author Wade Sexton More articles by this author Scott Gilbert More articles by this author Brandon Manley More articles by this author Expand All Advertisement Loading ...