Abstract 2407
Background
The introduction of thyrosinkinase inhibitors (TKI) changed the treatment of mRCC. To elaborate the potential impact of TKI therapies, we studied trends in OS for patients diagnosed with primary mRCC between 1998 - 2015 in Austria.
Methods
All patients with primary mRCC (≥18 years), diagnosed from 1998 - 2015 were derived from the ANCR (n = 2,490). Patients diagnosed from 2004-2005 (n = 323) were excluded (transition period of systemic therapies). To evaluate survival differences between patients treated before and after the introduction of Sunitinib (preTKI-era and TKI-era), 3 periods were defined: 1998 - 2003 (preTKI-era; N = 937), 2006 - 2010 (TKI-era P1; N = 687) and 2011 - 2015 (TKI-era P2; N = 543). Follow-up was complete until Dec. 31st, 2016. The Cox proportional hazard model was used to calculate hazard ratios (HR).
Results
A total of 2,167 patients were included, median age was 70 yrs in the 3 eras. The incidence of T1 tumors increased from 6.9% in the preTKI-era to 10% in the TKI-era while T4 tumors decreased from 15% to 8% (p <.001). Surgery rate declined from 50% in the preTKI-era to 43% in 2011-2015 (p =.02). 5-year RS for patients undergoing surgery slightly increased from 18% in the preTKI-era to 23% in TKI-era P1 (p =.04). For patients without surgery 5-year OS improved from 5.2% in the preTKI-era to 9.1% in TKI-era P1 (p <.001). Further survival gain was observed in patients < 75 yrs of + 6% (p =.01), patients > = 75 years of + 0.2% (p =.03) and for T3/T4 tumors of + 6% (p =.002). The Relative Excess Risk of dying (RER) for patients treated in the TKI-eras was reduced compared to the preTKI-era (HR 0.78, 95% CI 0.76-0.95) adjusted for sex, age, T-stage and surgery. Survival advantage for patients undergoing surgery remained significant (HR: 0.46, 95% CI 0.41-0.52) after adjustment for TKI-era, sex, age, T-stage.
Conclusions
Patients treated in the TKI era show improved RS compared to the cytokine era. Most benefit was observed in non-surgical patients, younger patients and for T3/T4 disease. Surgery contributed to an additional survival benefit.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Priv. Doz. Dr. Martin Marszalek.
Funding
Pfizer Austria.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3128 - Systemic bevacizumab for the treatment of recurrent respiratory papillomatosis: A retrospective analysis from an academic tertiary care center
Presenter: Sumita Trivedi
Session: Poster Display session 3
Resources:
Abstract
1242 - Monalizumab in combination with cetuximab in patients (pts) with recurrent or metastatic (R/M) head and neck cancer (SCCHN) previously treated or not with PD-(L)1 inhibitors (IO): 1-year survival data.
Presenter: Roger Cohen
Session: Poster Display session 3
Resources:
Abstract
4703 - Updated results of a phase II study evaluating accelerator-based boron neutron capture therapy (AB-BNCT) with borofalan(10B) (SPM-011) in recurrent squamous cell carcinoma (R-SCC-HN) and recurrent and locally advanced non-SCC (R/LA-nSCC-HN) of the head and neck
Presenter: Katsumi Hirose
Session: Poster Display session 3
Resources:
Abstract
3638 - Phase 3 KEYNOTE-048 Study of First-Line (1L) Pembrolizumab (P) for Recurrent/Metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC): Asia vs Non-Asia Subgroup (subgrp) Analysis
Presenter: Makoto Tahara
Session: Poster Display session 3
Resources:
Abstract
2954 - Integrated data review evaluating safety, pharmacokinetics (PK) and immunogenicity of RM-1929 photoimmunotherapy (PIT) in subjects with locoregional, recurrent head and neck squamous cell carcinoma (rHNSCC).
Presenter: Jennifer Johnson
Session: Poster Display session 3
Resources:
Abstract
3629 - First line versus second line immunotherapy in recurrent/metastatic squamous cell carcinoma of the head and neck
Presenter: Caroline Even
Session: Poster Display session 3
Resources:
Abstract
767 - Sensitizing HRAS overexpressing head and neck squamous cell carcinoma (HNSCC) to chemotherapy
Presenter: Theodoros Rampias
Session: Poster Display session 3
Resources:
Abstract
4985 - A Single-Arm, Open-Label, Multicenter, Phase IIIb Clinical Trial with Nivolumab in Subjects with Recurrent or Metastatic Platinum-refractory Squamous Cell Carcinoma of the Head and Neck.
Presenter: Paolo Bossi
Session: Poster Display session 3
Resources:
Abstract
1564 - Long-term Results of Phase 2 Trial of Reduced Modified Clinical Target Volume in Low-risk Nasopharyngeal Carcinoma Treated with Intensity Modulated Radiotherapy
Presenter: Jingjing Miao
Session: Poster Display session 3
Resources:
Abstract
3356 - To compare two oral mucosa contouring methods in predicting acute oral mucocitis in nasopharyngeal carcinoma treated with helical tomotherapy
Presenter: Yuan-Yuan Chen
Session: Poster Display session 3
Resources:
Abstract