Assistant Attending, Department of Medicine Memorial Sloan Kettering Cancer Center, New York, NY, United States
Background: IO based therapies have changed the treatment paradigm in the first-line (1L) mRCC in the last few years with robust clinical trial data. We performed comparison of real-world (rw) data for P+A with I+N for clinical outcomes among mRCC pts in community oncology setting.
Methods: This retrospective cohort study used structured and chart review data from iKnowMed, a US community Oncology electronic health record database to identify adult clear cell mRCC pts initiating 1L P+A or I+N from 4/1/2019 to 12/31/2020 who were followed through 3/31/2021. Treatment pattern & physician-recorded response (rw-overall response rate[rwORR] & rw-disease control rate [rwDCR]) were assessed descriptively. rw-time on treatment (rwToT), rw-time to next treatment (rwTTNT), overall survival (OS) & progression-free survival (PFS) were estimated using Kaplan-Meier method.
Results: Study included 331 eligible pts (P+A=44% [n=145], I+N=56% [n=186]). Median age was 65 years (Range, 59-73), 76% (n=250) were male, & 82%(P+A=76%, I+N=88%) had intermediate/poor (I/P) IMDC risk score. Median follow-up was 10.1 (Range, 5.8 - 14.7) for P+A & 10.7 (Range, 5.2 - 15.4) months for I+N. Overall, 25% (n = 83) & 11% (n = 35) pts received second-line (2L) & third-line treatments, respectively. Cabozantinib (52%) was the most common 2L treatment. The rwORR & rwDCR were 71%, 80% & 45%, 59% for P+A & I+N, respectively. 12-month OS rate was 82.5% for P+A & 71.1% for I+N. 12-month rwTTNT, rwToT & rwPFS rate was 61.9%, 47.2%, & 55.0% for P+A & 47.0%, 26.3% & 44.9% for I+N, respectively. Clinical outcomes data for entire cohort & I/P are presented in table.
Conclusions: Our rw study of treatment exposure (rwTTNT, rwToT & PFS) of IO based mRCC treatments in the US community oncology setting provides insights into their effectiveness, tolerability, &/or compliance. Longer follow-up is needed to better characterize OS
