Abstract 34P
Background
Little research exists on real-world (RW) treatment patterns and outcomes for newly evolving immuno-oncology (IO) combination and targeted therapy regimens recently added to the National Comprehensive Cancer Network (NCCN) guidelines for aRCC. The objective of this study was to characterize patient characteristics and treatment patterns of patients with aRCC treated with IO and tyrosine kinase inhibitor (TKI) monotherapy (mono) and combination (combo) regimens in RW clinical practice.
Methods
This retrospective cohort study of patients with aRCC treated at oncology practices in the US used a Flatiron Health (FH) electronic health record-derived, de-identified database curated to include patients with ≥ 2 RCC ICD codes (ICD-9: 198.x or ICD-10: C64-C65), clinical confirmation of stage IV, and who received pembrolizumab, nivolumab, ipilimumab, atezolizumab, durvalumab, or avelumab in any line. The study included patients on the following FH-curated, first-line (1L) regimens, IO+IO combo, IO mono, TKI mono or IO+TKI combo, initiated between April 2018 and December 2019. Patient characteristics and clinical factors were analyzed descriptively for the above cohorts.
Results
Of 938 patients with aRCC treated with 1L regimens of interest, > 90.0% were treated in community settings. The most prevalent 1L regimen was IO+IO combo, with 441 patients (45.8%). TKI mono represented 185 patients (19.2%), IO+TKI combo, 177 (18.4%), and IO mono, 135 (14.0%). Baseline demographics and clinical factors identified within 60 days of the start of 1L therapy by cohort are described in the table. Table: 34P
Baseline patient demographics and clinical characteristics among 1L aRCC treatment cohorts
| IO+IO Combo n= 441 | IO Mono n = 135 | TKI Mono n = 185 | IO + TKI Combo n = 177 | |
| Age, years Mean (SD) | 65.21 (10.5) | 70.66 (10.5) | 67.30 (10.1) | 65.82 (10.2) |
| Sex, n (%) F M | 112 (25.4) 329 (74.6) | 61 (45.2) 74 (54.8) | 43 (23.2) 142 (76.8) | 60 (33.9) 117 (66.1) |
| Race, n (%) White Other Unknown Black or Afr Am Asian | 291 (66.0) 70 (15.9) 44 (10.0) 30 (6.8) 6 (1.4) | 97 (71.9) 11 (8.1) 13 (9.6) 13 (9.6) 1 (0.7) | 114 (61.6) 34 (18.4) 18 (9.7) 14 (7.6) 5 (2.7) | 113 (63.8) 25 (14.1) 29 (16.4) 10 (5.6) 0 (0) |
| ECOG, n (%) 0 1 2 ≥3+ | 167 (37.9) 126 (28.6) 19 (4.3) 8 (1.8) | 41 (30.4) 38 (28.1) 22 (16.3) 1 (0.7) | 73 (39.5) 52 (28.1) 9 (4.9) 0 (0) | 81 (45.8) 53 (29.9) 14 (7.9) 1 (0) |
Conclusions
RW data provide insight into how physicians and patients adapt to new treatment guidelines. These data demonstrate an increase in prescribing of IO+TKI regimens as 1L treatment since their approval in April 2019. Future work will explore outcomes for these new therapies once increased follow-up time is available.
Legal entity responsible for the study
Pfizer, Inc.
Funding
Pfizer, Inc.
Disclosure
All authors have declared no conflicts of interest.