Impact of Immunotherapy on Real-World Survival Outcomes in Metastatic Renal Cell Carcinoma.

Treatment options for metastatic renal cell carcinoma (mRCC) are rapidly expanding, and immunotherapy using checkpoint inhibitors is a first- or second-line option for most patients.

The objective of the present retrospective analysis was to explore the real-world impact of checkpoint inhibitor-based immunotherapy compared with therapy using other types of targeted therapies using a large real-world database.

RenIS, a registry of patients with mRCC was used as a data source. Outcomes were compared for cohorts treated with TKIs or mTOR inhibitors only [targeted therapy (TT) cohort] versus patients who received immunotherapy (IO) using a checkpoint inhibitor in any line of treatment (IO cohort). Data from a total of 1981 patients were extracted from the registry, including 1767 patients in the TT cohort and 214 patients in the IO cohort.

The median overall survival from the initiation of first-line treatment was 24.5 months versus not reached (p < 0.001) in the TT cohort versus the IO cohort, respectively [HR 0.23, 95% CI (0.17-0.31), p < 0.001]. The probability of 5-year survival was 24.2 versus 67.9% in the TT cohort versus the IO cohort, respectively. Immunotherapy in any line of treatment was associated with a lower risk of death. Overall survival was superior for patients receiving immunotherapy as the first or second treatment line compared with patients treated with non-immunological targeted therapy.

In real-world patients with mRCC, immunotherapy is associated with significant survival benefit. The present retrospective analysis shows the real-world benefit of second-line immunotherapy in patients previously treated with tyrosine-kinase inhibitors.

Targeted oncology. 2023 Nov 13 [Epub ahead of print]

Alexandr Poprach, Igor Kiss, Michal Stanik, Tamara Barusova, Lenka Pospisilova, Ondrej Fiala, Jindrich Kopecky, Igor Richter, Bohuslav Melichar, Hana Studentova, Radek Lakomy, Milos Holanek, Aneta Rozsypalova, Anezka Zemanková, Marek Svoboda, Tomas Buchler

Department of Comprehensive Cancer Care and Faculty of Medicine, Masaryk Memorial Cancer Institute and Masaryk University, Brno, Czech Republic., Department of Urologic Oncology, Masaryk Memorial Cancer Institute and Masaryk University, Brno, Czech Republic., Institute of Biostatistics and Analyses Brno, Brno, Czech Republic., Department of Oncology and Radiotherapy, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic., University Hospital in Hradec Králové, Hradec Králové, Czech Republic., Department of Oncology, Liberec Regional Hospital, Liberec, Czech Republic., Department of Oncology, Palacky University Medical School and Teaching Hospital, Olomouc, Czech Republic., Department of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic., Department of Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, V Uvalu 84, 150 06, Prague, Czech Republic. .