Abstract 675P
Background
In Norway cancer treatment is publicly funded, providing equal care to all patients. Nationwide population registries capture data on diagnoses, treatment and comorbidities. This enabled us to collect data for this longitudinal retrospective study and describe clinical and demographic characteristics, treatment patterns and survival of patients with RCC.
Methods
Four data sources were used to identify adult patients diagnosed with RCC in the period from 01/1995 to 12/2018 and to collect the data; the Norwegian Prescription Database, the Norwegian Patient Register (NPR), the Norwegian Primary Care Register, and the Cancer Registry of Norway. Statistical analysis was performed by Kaplan-Meier method and multivariate regression models.
Results
Overall 12,767 patients were diagnosed with RCC in the study period and 4,150 had metastatic disease (mRCC). Median overall survival (mOS) was 9.34 and 1.17 years (y) in the whole RCC and mRCC cohort, respectively, with an incrementally improving OS between 1995 and 2018. Of 3,072 patients diagnosed with mRCC after January 1, 2008 (start of NPR) only 1,537 received at least one line of systemic therapy. Of those, 43% received only one line of therapy, 27% two lines, 15% three - and the remainder four or more therapy lines, with no changes between 2008 and 2019. Increasing number of therapy lines was related to longer mOS, 1.04, 1.59 and 2.62 y respectively for patients with one, two or three lines. Tyrosine kinase inhibitors (TKIs) were commonly used in first line, while use of mammalian target of rapamycin (mTOR) inhibitor decreased over time and was replaced with immunotherapy (IO) and TKIs in subsequent lines. Among the 401 patients who received three or more therapy lines, patients with IO as a part of their sequence had significantly longer mOS of 4.66 y compared to 2.47 y in patients never receiving IO.
Conclusions
This study represents a complete population-wide analysis of RCC patients in Norway over a period of 23 years, providing comprehensive real-world data on patient treatment and survival before and after introduction of new therapies. The results are in line with survival benefits reported in clinical trials and warrant use of modern therapies in daily clinical practice.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Pfizer Norge AS.
Disclosure
K. Puco: Financial Interests, Personal, Advisory Board: Astellas; Financial Interests, Personal, Invited Speaker: Astellas; Financial Interests, Personal, Invited Speaker: Ibsen; Financial Interests, Personal, Invited Speaker: Janssen-Cilag; Financial Interests, Personal, Invited Speaker: Merk; Financial Interests, Institutional, Principal Investigator: Merck Sharp&Dohme. C. Notland: Financial Interests, Personal, Full or part-time Employment: Pfizer Norway AS. R. Szulkin: Financial Interests, Personal, Full or part-time Employment: Pfizer. C. Jonasson: Financial Interests, Personal, Full or part-time Employment: Pfizer Norway AS. O. Solli: Financial Interests, Personal, Full or part-time Employment: Pfizer Norway AS. J. Oldenburg: Financial Interests, Personal, Advisory Board: Astellas; Financial Interests, Personal, Invited Speaker: Astellas; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Advisory Board: Atnahs; Financial Interests, Personal, Advisory Board: Bayer; Financial Interests, Personal, Invited Speaker: Bayer; Financial Interests, Personal, Invited Speaker: Bristol-Myers Squibb; Financial Interests, Personal, Invited Speaker: Dagens Medisin; Financial Interests, Personal, Advisory Board: Eisai; Financial Interests, Personal, Advisory Board: Ipsen; Financial Interests, Personal, Advisory Board: Janssen-Cilag; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: Merck; Financial Interests, Personal, Invited Speaker: Norwegian Prostate Cancer Association; Financial Interests, Personal, Advisory Board: NordiMed; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Institutional, Principal Investigator: Bristol-Myers Squibb; Financial Interests, Institutional, Principal Investigator: Merck; Financial Interests, Institutional, Principal Investigator: Pfizer; Financial Interests, Institutional, Principal Investigator: Sanofi. D. Heinrich: Financial Interests, Personal, Invited Speaker: AAA, a Novartis company; Financial Interests, Personal, Advisory Board: Astellas; Financial Interests, Personal, Invited Speaker: Astellas; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Invited Speaker: Bayer; Financial Interests, Personal, Advisory Board: Bayer; Financial Interests, Personal, Invited Speaker: Bristol-Myers Squibb; Financial Interests, Personal, Advisory Board: Eisai; Financial Interests, Personal, Invited Speaker: EUSA Pharma; Financial Interests, Personal, Invited Speaker: Ipsen; Financial Interests, Personal, Advisory Board: Ipsen; Financial Interests, Personal, Invited Speaker: Janssen-Cilaq; Financial Interests, Personal, Advisory Board: Janssen-Cilaq; Financial Interests, Personal, Invited Speaker: Novartis; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Invited Speaker: Sanofi-Aventis; Financial Interests, Institutional, Principal Investigator: AstraZeneca; Financial Interests, Institutional, Principal Investigator: Bristol-Myers Squibb; Financial Interests, Institutional, Principal Investigator: Eisai; Financial Interests, Institutional, Principal Investigator: Janssen-Cilaq; Financial Interests, Institutional, Principal Investigator: Merck Sharp & Dome; Financial Interests, Institutional, Principal Investigator: Pfizer; Financial Interests, Institutional, Principal Investigator: Roche; Non-Financial Interests, Personal, Leadership Role: Norwegian Association of Oncology; Non-Financial Interests, Personal, Advisory Role: Standing Commitee of European Doctors. All other authors have declared no conflicts of interest.