21P - Evaluating Renal Cell Carcinoma treatment options using real world data: findings from an oncology survey across seven countries (21P)

Date 08 December 2017
Event ESMO Immuno-Oncology Congress 2017
Session Lunch & Poster Display session
Topics Cancer Immunology and Immunotherapy
Head and Neck Cancers
Presenter Sheila Mpima
Citation Annals of Oncology (2017) 28 (suppl_11): xi6-xi29. 10.1093/annonc/mdx711
Authors S. Mpima, S. Menon, P. Nasuti, H. Mistry
  • Rwi Oncology, QuintilesIMS (UK), N1 9JY - London/GB

Abstract

Background

Renal Cell Carcinoma (RCC) has always been considered an immunogenic tumour with immunostimulatory therapeutic approaches like interleukins and interferons being cornerstone in the 1990s. Clinical data supports the hypothesis that the PD-1/PDL1 interaction is an important regulator in tumour immune tolerance and tumour growth in RCC. No prognostic or predictive biomarkers have previously been identified leaving testing an unknown in RCC. The objective is to evaluate current real-world treatment patterns including PD-L1 expression testing in RCC.

Methods

This study used a QuintilesIMS oncology specific cross-sectional survey collecting anonymized patient-level oncology data in EU4 (France, Germany, Spain, UK) and Asia (China, Japan, Korea) between January – June 2017.

Results

Of the 2,413 surveyed patients, 79% were prescribed Tyrosine Kinase Inhibitors (TKIs), 7% mTOR inhibitors, 2% interferons/interleukins, 9% anti-PD-1/PD-L1 treatments (4% Asia vs 10% EU4). The majority of patients were prescribed anti-PD-1/PD-L1 treatments as monotherapy with under 1% prescribed in combination with TKIs. 97% of patients receiving an anti-PD-1/PD-L1 drug had completed another treatment prior to receiving checkpoint inhibitors while other 3% were new to treatment. The most common previous therapies were TKIs (82%) followed by mTOR inhibitors (26%), and the reason for discontinuation was primarily disease progression (86%).In 70% of patients treated with anti-PD1 treatments the disease metastasised to two or more organs. 22% of RCC patients were tested for PD-1/PDL1 expression in EU4 while none were tested in Asia.

Conclusions

PD-1/PD-L1 inhibitors are mainly being prescribed to patients with RCC that have completed at least one line of treatment and who have manifested disease progression. The precise role of PD-L1 positivity remains to be defined within this patient segment as testing rates for expression remain really low or non-existent in some countries. Further analysis will be required to understand the time to PD-1/PDL1 expression testing and to understand difference in typical patient profile of patients treated with standard of care vs anti-PD-1/PD-L1 treatments.

Clinical trial identification

Legal entity responsible for the study

N/A

Funding

None

Disclosure

All authors have declared no conflicts of interest.