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

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.

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.

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.

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.

Clinical genitourinary cancer. 2023 Nov 24 [Epub ahead of print]

Laurence Albigès, Carine Bellera, Sébastien Branchoux, Mickael Arnaud, Amandine Gouverneur, Sonia Néré, Anne-Françoise Gaudin, Isabelle Durand-Zaleski, Sylvie Négrier

Institut Gustave Roussy, Paris, France. Electronic address: ., Department of Clinical Epidemiology and Clinical Research, Institut Bergonié, Bordeaux, France., Department of Health Economics & Outcomes Research, Bristol Myers Squibb, Rueil-Malmaison, France., IQVIA, Real World Solutions, Bordeaux, France., Department of Medical Affairs, Bristol Myers Squibb, Rueil-Malmaison, France., AP-HP Hôtel Dieu, Clinical Research Unit Eco Ile de France, Paris, France., Université Lyon I, Centre Léon Bérard, Lyon, France.