Characterization of Patients With Metastatic Renal Cell Carcinoma Experiencing Complete Response to First-line Therapies : Results From the International Metastatic Renal Cell Carcinoma Database Consortium
PURPOSE: Clinical trials have demonstrated higher complete response rates in the immuno-oncology-based combination arms than in the tyrosine kinase inhibitor arms in patients with metastatic renal cell carcinoma. We aimed to characterize real-world patients who experienced complete response to the contemporary first-line therapies.
MATERIALS AND METHODS: Using the International Metastatic Renal Cell Carcinoma Database Consortium, response-evaluable patients who received frontline immuno-oncology-based combination therapy or tyrosine kinase inhibitor monotherapy were analyzed. Baseline characteristics of patients and post-landmark overall survival were compared based on best overall response, as per RECIST 1.1.
RESULTS: A total of 52 (4.6%) of 1,126 and 223 (3.0%) of 7,557 patients experienced complete response to immuno-oncology-based and tyrosine kinase inhibitor therapies, respectively (P = .005). An adjusted odds ratio for complete response achieved by immuno-oncology-based combination therapy (vs tyrosine kinase inhibitor monotherapy) was 1.56 (95% CI 1.11-2.17; P = .009). Among patients who experienced complete response, the immuno-oncology-based cohort had a higher proportion of non-clear cell histology (15.9% and 4.7%; P = .016), sarcomatoid dedifferentiation (29.8% and 13.5%; P = .014), and multiple sites of metastases (80.4% and 50.0%; P < .001) than the tyrosine kinase inhibitor cohort. Complete response was independently associated with post-landmark overall survival benefit in both the immuno-oncology-based and tyrosine kinase inhibitor cohorts, giving respective adjusted hazard ratios of 0.17 (95% CI 0.04-0.72; P = .016) and 0.28 (95% CI 0.21-0.38; P < .001).
CONCLUSIONS: The complete response rate was not as high in the real-world population as in the clinical trial population. Among those who experienced complete response, several adverse clinicopathological features were more frequently observed in the immuno-oncology-based cohort than in the tyrosine kinase inhibitor cohort. Complete response was an indicator of favorable overall survival.
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:209 |
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| Enthalten in: |
The Journal of urology - 209(2023), 4 vom: 06. Apr., Seite 701-709 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Takemura, Kosuke [VerfasserIn] |
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| Anmerkungen: |
Date Completed 10.03.2023 Date Revised 22.03.2023 published: Print-Electronic CommentIn: J Urol. 2023 Apr;209(4):709. - PMID 36700384 Citation Status MEDLINE |
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| doi: |
10.1097/JU.0000000000003132 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM350853940 |
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| 041 | |a eng | ||
| 100 | 1 | |a Takemura, Kosuke |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Characterization of Patients With Metastatic Renal Cell Carcinoma Experiencing Complete Response to First-line Therapies |b Results From the International Metastatic Renal Cell Carcinoma Database Consortium |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 10.03.2023 | ||
| 500 | |a Date Revised 22.03.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Urol. 2023 Apr;209(4):709. - PMID 36700384 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: Clinical trials have demonstrated higher complete response rates in the immuno-oncology-based combination arms than in the tyrosine kinase inhibitor arms in patients with metastatic renal cell carcinoma. We aimed to characterize real-world patients who experienced complete response to the contemporary first-line therapies | ||
| 520 | |a MATERIALS AND METHODS: Using the International Metastatic Renal Cell Carcinoma Database Consortium, response-evaluable patients who received frontline immuno-oncology-based combination therapy or tyrosine kinase inhibitor monotherapy were analyzed. Baseline characteristics of patients and post-landmark overall survival were compared based on best overall response, as per RECIST 1.1 | ||
| 520 | |a RESULTS: A total of 52 (4.6%) of 1,126 and 223 (3.0%) of 7,557 patients experienced complete response to immuno-oncology-based and tyrosine kinase inhibitor therapies, respectively (P = .005). An adjusted odds ratio for complete response achieved by immuno-oncology-based combination therapy (vs tyrosine kinase inhibitor monotherapy) was 1.56 (95% CI 1.11-2.17; P = .009). Among patients who experienced complete response, the immuno-oncology-based cohort had a higher proportion of non-clear cell histology (15.9% and 4.7%; P = .016), sarcomatoid dedifferentiation (29.8% and 13.5%; P = .014), and multiple sites of metastases (80.4% and 50.0%; P < .001) than the tyrosine kinase inhibitor cohort. Complete response was independently associated with post-landmark overall survival benefit in both the immuno-oncology-based and tyrosine kinase inhibitor cohorts, giving respective adjusted hazard ratios of 0.17 (95% CI 0.04-0.72; P = .016) and 0.28 (95% CI 0.21-0.38; P < .001) | ||
| 520 | |a CONCLUSIONS: The complete response rate was not as high in the real-world population as in the clinical trial population. Among those who experienced complete response, several adverse clinicopathological features were more frequently observed in the immuno-oncology-based cohort than in the tyrosine kinase inhibitor cohort. Complete response was an indicator of favorable overall survival | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a carcinoma, renal cell | |
| 650 | 4 | |a immune checkpoint inhibitors | |
| 650 | 4 | |a prognosis | |
| 650 | 4 | |a receptors | |
| 650 | 4 | |a remission induction | |
| 650 | 4 | |a vascular endothelial growth factor | |
| 650 | 7 | |a Protein Kinase Inhibitors |2 NLM | |
| 700 | 1 | |a Navani, Vishal |e verfasserin |4 aut | |
| 700 | 1 | |a Ernst, Matthew S |e verfasserin |4 aut | |
| 700 | 1 | |a Wells, J Connor |e verfasserin |4 aut | |
| 700 | 1 | |a Meza, Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Pal, Sumanta K |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Jae-Lyun |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Haoran |e verfasserin |4 aut | |
| 700 | 1 | |a Agarwal, Neeraj |e verfasserin |4 aut | |
| 700 | 1 | |a Alva, Ajjai S |e verfasserin |4 aut | |
| 700 | 1 | |a Hansen, Aaron R |e verfasserin |4 aut | |
| 700 | 1 | |a Basappa, Naveen S |e verfasserin |4 aut | |
| 700 | 1 | |a Szabados, Bernadett |e verfasserin |4 aut | |
| 700 | 1 | |a Powles, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Tran, Ben |e verfasserin |4 aut | |
| 700 | 1 | |a Hocking, Christopher M |e verfasserin |4 aut | |
| 700 | 1 | |a Beuselinck, Benoit |e verfasserin |4 aut | |
| 700 | 1 | |a Yuasa, Takeshi |e verfasserin |4 aut | |
| 700 | 1 | |a Choueiri, Toni K |e verfasserin |4 aut | |
| 700 | 1 | |a Heng, Daniel Y C |e verfasserin |4 aut | |
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