The present retrospective, longitudinal cohort study assessed the association between the first-line sunitinib treatment duration and clinical outcomes with second-line immuno-oncology (IO) therapy among patients with metastatic renal cell carcinoma (mRCC).
A total of 161 patients with mRCC who had been treated with first-line sunitinib and subsequent IO therapy from select International mRCC Database Consortium centers were included. The overall survival, time to next therapy, time to treatment discontinuation, and real-world physician-assessed best response measured from IO therapy initiation were analyzed and compared between patients treated with first-line sunitinib for ≥ 6 months and those treated for < 6 months.
The 116 patients treated with sunitinib for ≥ 6 months tended to be older and to have a better International mRCC Database Consortium risk than the 45 patients treated for < 6 months (favorable, 36% vs. 8%, P = .001; intermediate, 59% vs. 70%, P = .21; poor, 5% vs. 22%, P = .007). The receipt of sunitinib for ≥ 6 months versus < 6 months was associated with longer survival (hazard ratio [HR], 0.42; 95% confidence interval [CI], 0.21-0.87; P = .02). No significant association was observed between the first-line sunitinib duration and second-line IO outcomes, including the time to next therapy (HR, 0.89; 95% CI, 0.52-1.51; P = .66), time to treatment discontinuation (HR, 0.85; 95% CI, 0.54-1.34; P = .49), and tumor response (odds ratio, 0.73; 95% CI, 0.22-2.49; P = .62).
We found no statistically significant association between the first-line sunitinib duration and clinical outcomes with second-line IO therapy. Patients receiving first-line sunitinib for ≥ 6 months compared with < 6 months was associated with better overall survival, although potential unadjusted confounders could have been present. These findings support the paradigm that previous therapy will not dictate the effectiveness of subsequent immunotherapy.
Clinical genitourinary cancer. 2019 Dec 13 [Epub ahead of print]
J Connor Wells, Jeffrey Graham, Benoit Beuselinck, Georg A Bjarnason, Frede Donskov, Aaron R Hansen, Rana R McKay, Ulka Vaishampayan, Guillermo De Velasco, Mei S Duh, Lynn Huynh, Catherine Nguyen, Giovanni Zanotti, Krishnan Ramaswamy, Toni K Choueiri, Daniel Y C Heng
Department of Oncology, University of Calgary, Calgary, AB, Canada., Department of Oncology, CancerCare Manitoba, University of Manitoba, Winnipeg, MB, Canada., Department of Oncology, University Hospital Leuven, Kathoieke Universiteit Leuven, Leuven, Belgium., Department of Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada., Department of Oncology, Aarhus University Hospital, Aarhus, Denmark., Department of Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada., Department of Oncology, University of California, San Diego, San Diego, CA., Department of Oncology, Karmanos Cancer Institute, Detroit, MI., Department of Oncology, University Hospital 12 de Octubre, Madrid, Spain., Analysis Group, Inc, Boston, MA., Pfizer, Inc, New York, NY., Department of Oncology, Dana-Farber Cancer Institute, Boston, MA., Department of Oncology, University of Calgary, Calgary, AB, Canada. Electronic address: .