Abstract 681P
Background
Clinical trials have demonstrated the efficacy of several therapies for mRCC, yet RW data on their effectiveness including by prognostic risk groups and histology are limited. This retrospective study estimated RW progression-free survival (PFS) and overall survival (OS) in patients with mRCC.
Methods
Adults with mRCC who received first-line (1L) therapy between Apr 2018 and Dec 2020 were included from the nationwide Flatiron Health electronic medical record–derived de-identified database. Potential median follow-up from 1L mRCC therapy initiation date (index date), median PFS (mPFS), median OS (mOS), and 6-month probability were computed from index date for the overall cohort and the following 6 subgroups: IMDC intermediate/poor-risk group (I/P), IMDC favorable-risk group (FAV), patients with clear cell (CC), non-clear cell (nCC) histology, other histology, and immuno-oncology-experienced (IO-exp) patients (defined as patients who received any IO therapy in 1L and in any subsequent line).
Results
Among the overall cohort (N = 1782), the median age was 68.0 years. Most were male (71.0%), from a community practice (90.0%), had IMDC I/P-risk (79.2%), and had CC histology (69.8%); 159 patients were IO-exp. In the overall cohort, the most common 1L therapy was IO-based combination therapy (58.1%) followed by TKI monotherapy (28.9%). In addition, potential median (range) follow-up for the overall cohort was 18.9 (1.1–34.1) months. PFS and OS outcomes are shown in the table for all subgroups. In the overall cohort, mOS was 23.0 months and for those who were IO-exp, mOS was 28.7 months. Moreover, mOS was longer in patients with CC (27.0 months) versus nCC (15.5 months) or other histology (11.9 months). Table: 681P
PFS and OS outcomes
| Overall cohort (N = 1782) | FAV (n = 155) | I/P (n = 1412) | CC (n = 1244) | nCC (n = 167) | Other histology (n = 371) | IO-exp (n = 159) | |
| mPFS (95% CI), months | 6.8 (6.2–7.5) | 13.4 (8.7–21.7) | 5.8 (5.4–6.4) | 7.9 (7.1–9.0) | 5.1 (4.3–6.3) | 4.9 (4.1–5.7) | 6.3 (5.2–7.4) |
| 6-month PFS probability (95% CI), % | 53.0 (50.5–55.5) | 72.7 (64.4–79.4) | 48.6 (45.8–51.3) | 56.9 (53.9–59.8) | 45.4 (37.4–53.1) | 43.3 (37.8–48.7) | 50.4 (42.0–58.1) |
| mOS (95% CI), months | 23.0 (20.6–25.4) | NR (31.1–NR) | 18.3 (16.3–20.6) | 27.0 (25.0–29.6) | 15.5 (11.5–22.4) | 11.9 (9.4–15.8) | 28.7 (25.4–NR) |
| 6-month OS probability (95% CI), % | 78.4 (76.3–80.3) | 95.2 (90.1–97.7) | 75.1 (72.6–77.3) | 82.7 (80.4–84.7) | 73.3 (65.6–79.5) | 65.9 (60.6–70.7) | 94.1 (89.0–96.9) |
NR, not reached
Conclusions
These results provide important context for evaluating RW clinical outcomes in mRCC patients mainly in a US community oncology setting, including patients by IMDC score and by histology. Future analysis of this cohort is planned to examine outcomes by therapy class.
Clinical trial identification
Editorial acknowledgement
Editorial assistance was provided by Parexel, funded by Bristol Myers Squibb.
Legal entity responsible for the study
Bristol Myers Squibb.
Funding
Bristol Myers Squibb.
Disclosure
S. George: Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Advisory Board: Bayer; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: Exelixis; Financial Interests, Personal, Advisory Board: Corvus Pharmaceuticals; Financial Interests, Personal, Advisory Board: Sanofi/Genzyme; Financial Interests, Personal, Advisory Board: EMD Serono; Financial Interests, Personal, Advisory Board: Seattle Genetics/Astellas; Financial Interests, Personal, Advisory Board: Eisai; Financial Interests, Personal, Advisory Board: Merck; Financial Interests, Personal, Advisory Board: AVEO; Financial Interests, Personal, Advisory Board: QED Therapeutics; Financial Interests, Institutional, Research Grant: Pfizer; Financial Interests, Institutional, Research Grant: Merck; Financial Interests, Institutional, Research Grant: Agensys; Financial Interests, Institutional, Research Grant: Novartis; Financial Interests, Institutional, Research Grant: BMS; Financial Interests, Institutional, Research Grant: Bayer; Financial Interests, Institutional, Research Grant: Eisai; Financial Interests, Institutional, Research Grant: Seattle Genetics/Astellas; Financial Interests, Institutional, Research Grant: Calithera Biosciences; Financial Interests, Institutional, Research Grant: Immunomedics; Financial Interests, Institutional, Research Grant: Corvus Pharmaceuticals; Financial Interests, Institutional, Research Grant: Surface Oncology. J. Faccone: Financial Interests, Personal, Full or part-time Employment: BMS; Financial Interests, Personal, Stocks/Shares: Accolade; Financial Interests, Personal, Stocks/Shares: BMS. S. Huo: Financial Interests, Personal, Full or part-time Employment: BMS; Financial Interests, Personal, Stocks/Shares: BMS. Y. Zhang: Financial Interests, Personal, Full or part-time Employment: BMS; Financial Interests, Personal, Stocks/Shares: BMS. B. Stwalley: Financial Interests, Personal, Full or part-time Employment: BMS; Financial Interests, Personal, Stocks/Shares: BMS. M. Hamilton: Financial Interests, Personal, Full or part-time Employment: BMS; Financial Interests, Personal, Stocks/Shares: BMS. T.K. Le: Financial Interests, Personal, Full or part-time Employment: BMS; Financial Interests, Personal, Stocks/Shares: BMS. F. Ejzykowicz: Financial Interests, Personal, Full or part-time Employment: BMS; Financial Interests, Personal, Stocks/Shares: BMS.