Real-World Treatment Patterns and Effectiveness of Patients With Advanced Renal Cell Carcinoma: A Nationwide Observational Study.

BACKGROUND

Treatment landscape for advanced renal cell carcinoma (aRCC) has evolved quickly and few data about the real-world treatment patterns are available. This study aimed at describing the real-world treatment patterns and effectiveness of all systemic treatments available for aRCC in first and second-line treatment.

MATERIALS AND METHODS

A cohort of patients initiating a first-line systemic treatment for aRCC in 2016 was extracted from the French nationwide healthcare insurance system database (SNDS). The first-line treatment initiation date constituted the index date and patients were followed until death, loss to follow-up, or December 31, 2019, whichever occurred first. aRCC was identified using hospital diagnosis, long-term disease, or renal biopsy before index date. All analyses were performed for first and second-line treatment. Overall survival (OS) and time-to-next treatment or death (TNT-D) were estimated using Kaplan-Meier approach.

RESULTS

In 2016, 1629 patients initiated a first-line treatment for aRCC. Most of them were male (75.9%) and the median age was 67 years. Most of patients (91.7%) had received a tyrosine kinase inhibitor as first-line treatment, mainly sunitinib (64.4%), and 53.5% received a second-line, among which 43.7% nivolumab. Median OS (95% confidence interval [CI]) was 20.7 (95% CI:18.2-22.4) months from first-line treatment initiation and 15.4 (13.9-17.5) months from second-line treatment initiation. Median TNT-D were respectively 9.3 (9.7-12.1) months and 6.9 (5.9-7.7) months.

CONCLUSION

This study highlights the limited survival of aRCC patients These results provide a valuable baseline and highlight the need for innovation, such as immune checkpoint inhibitor-based combinations that have recently became first-line standard of care.

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure Laurence Albigès (LA) has received advisory or consulting or honoraria (all paid to Institution) from Astellas, BMS, Ipsen, Janssen, Merck, MSD, Novartis, Pfizer, EISAI, and Roche; and has received travel, accommodations, and expenses from BMS, MSD and Ipsen. Carine Bellera (CB) has received consulting fees from BMS. Isabelle Durand-Zaleski (IDZ) has received advisory board or educational sessions with personal fees from Amgen, BMS, Boston scientific, MSD, Pfizer, Roche, and Takeda. Sylvie Négrier (SyN) has honoraria from Pfizer, Ipsen, BMS, MSD Oncology, and EISAI.; and has received consulting or advisory role from Ipsen, MSD Oncology, and EISAI; and has received research funding from Pfizer, Ipsen, and MSD; and has received travel, accommodations, expenses from Pfizer, BMS, Ipsen, and MSD. Sébastien Branchoux (SB), Sonia Néré (SoN), Anne-Françoise Gaudin (AFG) are employees of BMS France. Mickael Arnaud (MA) and Amandine Gouverneur (AG) are employees of IQVIA, with which BMS France contracted to support data acquisition and analysis for this study.