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
2275 - Activating mutations in AKT1/PIK3CA are associated with poor clinical outcomes in metastatic prostate cancer (mPC)
Presenter: Simon Fu
Session: Poster Display session 3
Resources:
Abstract
1908 - Androgen Receptor (AR) Aberrations in Patients (Pts) With Metastatic Castration-Sensitive Prostate Cancer (mCSPC) Treated With Apalutamide (APA) Plus Androgen Deprivation Therapy (ADT) in TITAN
Presenter: Kim Chi
Session: Poster Display session 3
Resources:
Abstract
4058 - 68Ga-PSMA guided bone biopsies for molecular diagnostics in metastatic castration resistant prostate cancer patients
Presenter: Anouk de Jong
Session: Poster Display session 3
Resources:
Abstract
2226 - Spatial-Temporal Change in Quantitative Total Bone Imaging (QTBI) and Circulating Tumor Cells (CTCs) in Metastatic Castration-Resistant Prostate Cancer (mCRPC) Treated With Enzalutamide (ENZA)
Presenter: Glenn Liu
Session: Poster Display session 3
Resources:
Abstract
5795 - Efficacy of Enzalutamide in Hormone-sensitive Metastatic Prostate Cancer: Clinical Utility of 18F-Choline PET and Whole Body MRI.
Presenter: Susanne Osanto
Session: Poster Display session 3
Resources:
Abstract
899 - Urine extracellular vesicle GATA2 mRNA alone and in a multigene test predicts initial prostate biopsy result
Presenter: Jungreem Woo
Session: Poster Display session 3
Resources:
Abstract
3094 - Circulating tumor cell (CTC) genomic landscape in neuroendocrine prostate cancer (NEPC) by single cell copy number analysis
Presenter: Vincenza Conteduca
Session: Poster Display session 3
Resources:
Abstract
2527 - Circulating Tumor Cells (CTC) count and Prostate-Specific Antigen (PSA) response measures in metastatic Castration-Resistant Prostate Cancer (mCRPC) patients (pts) treated with Docetaxel (Doc)
Presenter: Rebeca Lozano Mejorada
Session: Poster Display session 3
Resources:
Abstract
6106 - Assessing the clinical relevance of drug–drug interactions (DDI) with darolutamide (DARO)
Presenter: Christian Zurth
Session: Poster Display session 3
Resources:
Abstract
2237 - KEYNOTE-921: phase 3 study of pembrolizumab (pembro) plus docetaxel and prednisone for enzalutamide (enza)- or abiraterone (abi)-pretreated patients (pts) with metastatic castration-resistant prostate cancer (mCRPC).
Presenter: Daniel Petrylak
Session: Poster Display session 3
Resources:
Abstract