ASCO 2017: Impact of geographic region on overall survival in patients with metastatic renal cell carcinoma: Results from a pooled clinical trials database

Chicago, IL ( Dr. Poisl-Fay and colleagues presented their pool analysis assessing the impact of geographic region on overall survival (OS) among patients with metastatic renal cell carcinoma (mRCC) at the genitourinary cancer poster session at the 2017 ASCO annual meeting. The authors hypothesized that health determinants may vary according to geographic region and may impact outcomes of patients enrolled in targeted therapy clinical trials.

The authors conducted a pooled analysis of patients with mRCC treated in phase II and III clinical trials, including clinical characteristics and survival data. There were 4,736 patients included in the analysis and patients were stratified geographically as US/Canada (n=1,544), Asia/Oceania/Africa (n=1,254), Western Europe (n=897), Eastern Europe (n=792), and Latin America (n=250). Patients in US/Canada more commonly had a prior nephrectomy (80%) and were more likely to have a BMI > 25kg/m2 (80.1%). Patients from Eastern Europe were the most likely to have IMDC poor risk disease (31.8%). Using Kaplan-Meier method and log-rank test, there was no statistically significant differences in OS when comparing US/Canada to other regions. When compared specifically to Western Europe, patients in US/Canada had improved OS (20.3 vs.17.4 months; HR: 1.15, 95%CI 1.03-1.30). All grade treatment-related adverse events were reported more frequently in US/Canada, however there were no significant differences in grade 3-5 adverse events between groups.

This is a novel study design, highlighting different baseline characteristics based on geography among patients with mRCC enrolled in clinical trials for targeted therapy. Despite these characteristics and potential challenges to access to care in different parts of the world, there were no differences in OS across all geographic regions. As the authors mention, further work assessing geographic differences in disease biology, access to care, and adverse event reporting will be the focus of future research.

Presented By: Andre Poisl Fay, PUCRS School of Medicine, Porto Alegre, Brazil

Co-Authors: Rana R. McKay, Xun Lin, Ronit Simantov, Toni K. Choueiri

Written By: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre
Twitter: @zklaassen_md

at the 2017 ASCO Annual Meeting - June 2 - 6, 2017 – Chicago, Illinois, USA