Comparative Analysis of Outcomes for Patients With Advanced Renal Cell Carcinoma: Immuno-Oncology Era Versus Tyrosine Kinase Inhibitor Era in the IMDC Favorable-risk Group.

Abstract

Background/aim: Scarce data are available on the changes in outcomes related to advanced renal cell carcinoma (RCC), from the previous tyrosine kinase inhibitor (TKI) era to the current immuno-oncology (IO) era, among patients in the IMDC favorable-risk group.

Patients and methods: Among 618 patients with previously untreated advanced RCC according to our database, 72 classified with an International Metastatic RCC Database Consortium (IMDC) favorable risk were selected. These patients were divided into two groups (IO and TKI eras) based on the treatments recognized as the standard of care at the time of their treatment. We compared the effectiveness and safety profiles according to the treatment era.

Results: Out of 72 patients, 31 (43%) were treated in the IO era and 41 (57%) in the TKI era. No significant differences were found in patient backgrounds (p>0.05). Progression-free survival (median: 23.0 vs. 29.3 months, p=0.547) and overall survival (median: not reached vs. 114.7 months, p=0.785) showed no significant difference between the two eras. The objective response rate was higher in the IO era (84% vs. 41%, p=0.0003), and the treatment era was an independent predictor of an objective response (odds ratio=0.14, p=0.0006). The rates of treatment interruption (65% vs. 46%, p=0.155) and discontinuation (32% vs. 22%, p=0.420) did not significantly differ between eras.

Conclusion: The implementation of IO therapies has enhanced tumor response rates among patients within the IMDC favorable-risk group, although extended follow-up is necessary to ascertain any survival benefits.