The ARON-1 study (NCT05287464) was designed to globally analyze real-world data of mRCC patients receiving first-line immuno-oncology combinations. This sub-analysis is focused on the role of upfront or delayed partial or radical CN in three geographical areas (Western Europe, Eastern Europe, and America/Asia).
Materials and Methods: We conducted a multicenter retrospective observational study in mRCC patients treated with first-line immune combinations from 55 centers in 19 countries. From 1152 patients in the ARON-1 dataset, we selected 651 patients with de novo mRCC. 255 patients (39%) had undergone CN, partial in 14% and radical in 86% of cases; 396 patients (61%) received first-line immune combinations without previous nephrectomy.
The primary endpoint was overall survival (OS) while progression-free survival (PFS) and tumor response rate were secondary endpoints.
Results: Median OS from the diagnosis of de novo mRCC was 41.6 months and not reached (NR) in the CN subgroup and 24.0 months in the no CN subgroup, respectively (p<0.001). Median OS from the start of first-line therapy was NR in patients who underwent CN and 22.4 months in the no CN subgroup (p<0.001). Patients who underwent CN reported longer OS compared to no CN in all three geographical areas (Western Europe: NR vs 23.7 months, p<0.001; Eastern Europe: NR vs 29.8 months, p=0.005; America/Asia: 57.3 months vs 25.5 months, p<0.001).
Conclusions: No significant differences in terms of patients’ outcomes seem to clearly emerge in our analysis, even if the rate CN and the choice of the type of first-line immune-based combination varies across the different Cancer Centers participating in the ARON-1 project.
Written by:
- Francesco Massari, Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Matteo Santoni, Unit of Oncology, Hospital of Macerata, Macerata, Italy