Overall and progression-free survival according to MSKCC scores in 1st line sunitinib treatment of metastatic renal cell carcinoma (mRCC)

Date 30 September 2019
Event ESMO 2019 Congress
Session Poster Display session 3
Topics Renal Cell Cancer
Presenter Jindrich Finek
Citation Annals of Oncology (2019) 30 (suppl_5): v356-v402. 10.1093/annonc/mdz249
Authors J. Finek1, A. Poprach2, B. Melichar3, J. Kopecky4, M. Zemanova4, T. Buchler5, K. Kopeckova6, T. Mlcoch7, T. Dolezal8, O. Fiala1
  • 1Department Of Oncology And Radiotherapy, Teaching hospital Pilsen and Faculty of Medicine in Pilsen, Charles University, Czech Republic, 30133 - Plzen/CZ
  • 2Clinic Of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic, 656 53 - Brno/CZ
  • 3Faculty Of Medicine And Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic, 77520 - Olomouc/CZ
  • 4Oncology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic, 500 05 - Hradec Kralove/CZ
  • 5Oncology, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic, 140 59 - Prague/CZ
  • 6Department Of Oncology, University Hospital Motol and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic, 15006 - Prague/CZ
  • 7Hta Department, Institute of Health Economics and Technology Assessment, 12000 - Prague/CZ
  • 8Department Of Pharmacology, Institute of Health Economics and Technology Assessment and Faculty of Medicine, Masaryk University, 12000 - Prague/CZ

Abstract

Background

Data on the efficacy and safety of all targeted therapies for metastatic renal cell carcinoma (mRCC) including sunitinib are collected in the Czech RENIS patient registry. RENIS thus provides a uniquely large sample of long-term effectiveness and prognostic data of sunitinib according to adverse/risk factors measured by the Memorial Sloan Kettering Cancer Center (MSKCC) score. The aim of this study was to analyze the long-term overall (OS) and progression-free survival (PFS) of sunitinib, when used as 1st line treatment, based on MSKCC risk group scores including MSKCC scores for two intermediate subgroups.

Methods

Data from mRCC patients treated using sunitinib in the 1st line were collected in RENIS between 06/2007 and 02/2018. OS/PFS were then stratified based on MSKCC scores: a) favorable risk (0 adverse factors (AF)), b) intermediate risk (pooled 1–2 AFs), and c) poor risk (3+ AFs). The OS/PFS of the intermediate risk group was further stratified into two subgroups: i) 1 AF and ii) 2 AFs. All OS/PFS data were analyzed using Kaplan-Meier estimates. Differences in OS/PFS between risk groups were assessed using median survival, 95% confidence intervals (CI), and the log-rank test. Then we assessed the OS/PFS for 1-, 3-, and 5-year survival.

Results

Over the 11-year follow-up, 2390 patients were treated using sunitinib with 806, 1450, and 134 patients in the favorable, intermediate, and poor MSKCC risk groups. The more favorable MSKCC risk group was accompanied by an improved OS and PFS (p < 0.001). Regarding the MSKCC for the two intermediate sub-groups, 1 AF was associated with improved survival compared to 2 AFs (p < 0.001) (Table).Table:

957P OS and PFS results for sunitinib treatment based on MSKCC risk groups

MSKCC favorableMSKCC intermediateMSKCC poorMSKCC intermediateAll patients
1 AF2 AFs
Overall survival
Median survival (95% CI)44.7months (40.9-50.5)24.1months (21.9-26.0)9.5months (7.2-14.1)28.2months (25.9-30.7)16.2months (14.5-20.2)28.5months (26.3-30.5)
1-year survival (95% CI)85.0% (82.4-87.6)69.1% (66.6-71.7)44.3% (35.0-53.7)74.3% (71.4-77.2)58.0% (53.1-62.9)73.3% (71.4-75.2)
3-year survival (95 %CI)57.3% (53.4-61.3)37.1% (34.1-40.1)9.6% (3.1-16.2)42.0% (38.3-45.7)26.3% (21.4-31.2)42.9% (40.5-45.2)
5-year survival (95% CI)35.6% (31.2-40.1)23.4% (20.4-26.4)3.2% (0.0-8.8)26.5% (22.7-30.3)16.5% (11.8-21.2)26.8% (24.3-29.2)
n80614501349694812390
Log-rank p-value< 0.001< 0.001-
Progression-free survival
Median survival (95% CI)17.0months (15.4-18.8)9.0months (8.3-9.5)4.5months (3.9-6.1)10.1months (9.4-11.4)6.2months (5.5-7.5)10.6months (9.9-11.5)
1-year survival (95% CI)61.8% (58.3-65.3)40.7% (38.0-43.4)20.8% (13.1-28.5)45.1% (41.8-48.4)31.6% (27.1-36.1)46.9% (44.7-49.0)
3-year survival (95 %CI)25.1% (21.7-28.5)13.0% (11.0-15.1)1.8% (0.0-5.1)15.9% (13.2-18.6)7.0% (4.2-9.7)16.6% (14.9-18.4)
5-year survival (95% CI)10.4% (7.7-13.2)8.0% (6.2-9.8)1.8% (0.0-5.1)9.7 (7.3-12.0)4.5% (2.1-6.9)8.4% (7.0-9.9)
n80614501349694812390
Log-rank p-value< 0.001< 0.001-

Conclusions

Better MSKCC risk scores were associated with significantly longer OS and PFS. To our knowledge, this is the largest published sunitinib mRCC cohort described relative to MSKCC risk groups.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

J. Finek: Honoraria (self): Amgen; Honoraria (self): BMS; Honoraria (self): Roche; Honoraria (self): Bayer; Honoraria (self): Teva; Honoraria (self): MSD; Honoraria (self): Merck; Honoraria (self): Sanofi; Honoraria (self): Pierre Fabre. A. Poprach: Honoraria (self): Pfizer; Honoraria (self): Roche; Honoraria (self): Ipsen; Honoraria (self): Novartis; Honoraria (self): BMS; Honoraria (self): Bayer. B. Melichar: Honoraria (self): BMS; Honoraria (self): Merck; Honoraria (self): MSD; Honoraria (self): Roche; Honoraria (self): Novartis; Honoraria (self): Astellas Pharma; Honoraria (self): Pfizer; Honoraria (self): Bayer. J. Kopecky: Honoraria (self): BMS; Honoraria (self): Novartis; Honoraria (self): Pfizer. M. Zemanova: Advisory / Consultancy: Novartis; Honoraria (self): Eli Lilly; Travel / Accommodation / Expenses: MSD; Travel / Accommodation / Expenses: Boehringer Ingelheim. T. Buchler: Honoraria (self): Amgen; Honoraria (self): Roche; Honoraria (self): Novartis; Honoraria (self): Pfizer; Advisory / Consultancy: Roche; Advisory / Consultancy: BMS; Advisory / Consultancy: Pfizer; Travel / Accommodation / Expenses: Janssen. K. Kopeckova: Honoraria (self): Novartis; Travel / Accommodation / Expenses: Bayer; Travel / Accommodation / Expenses: Pfizer. T. Mlcoch: Full / Part-time employment: Value Outcomes. T. Dolezal: Full / Part-time employment: Value Outcomes. All other authors have declared no conflicts of interest.