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A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Observational study on the evolution of systemic treatments for advanced renal cell carcinoma in Southwest Finland
Olivia Hölsä1, Kaisa Teittinen2, Anna Anttalainen1
1Medaffcon Oy, Espoo, Finland.
Background:
Novel receptor tyrosine kinase inhibitors and immune checkpoint inhibitors have been introduced to the treatment of advanced renal cell carcinoma (aRCC) during the past decade. However, the adoption of novel treatments into clinical practice has been unknown in Finland.
Objectives:
Our aim was to evaluate the use of systemic treatments and treatment outcomes of aRCC patients in Southwest Finland during 2010-2021.
Design And Methods:
Clinical characteristics, treatments for aRCC, healthcare resource utilization, and overall survival (OS) were retrospectively obtained from electronic medical records. Patients were stratified using the International Metastatic RCC Database Consortium (IMDC) risk classification.
Results:
In total, 1112 RCC patients were identified, 336 (30%) patients presented with aRCC, and 57% of them (n = 191) had received systemic treatment. Pre-2018, sunitinib (79%) was the most common first-line treatment, and pazopanib (17%), axitinib (17%), and cabozantinib (5%) were frequently used in the second-line. Post-2018, sunitinib (52%), cabozantinib (31%), and the combination of ipilimumab and nivolumab (10%) were most commonly used in the first-line, and cabozantinib (23%) in the second-line. Median OS for patients with favorable, intermediate, and poor risk were 61.9, 28.6, and 8.1 months, respectively. A total of 73%, 74%, and 35% of the patients with favorable, intermediate, and poor risk had received second-line systemic treatment. In poor-risk patients, the number of hospital inpatient days was twofold higher compared to intermediate and fourfold higher compared to favorable-risk patients.
Conclusion:
New treatment options were readily adopted into routine clinical practice after becoming reimbursed in Finland. OS and the need for hospitalization depended significantly on the IMDC risk category. Upfront combination treatments are warranted for poor-risk patients as the proportion of patients receiving second-line treatment is low.
Registration:
Clinical trial identifier: ClinicalTrials.gov NCT05363072.
Insights
Novel treatments for advanced renal cell carcinoma (aRCC) were adopted in Finland. Treatment outcomes and survival varied significantly by International Metastatic RCC Database Consortium (IMDC) risk classification.
Area of Science:
- Oncology
- Clinical Pharmacology
- Health Services Research
Background:
- Recent advancements in oncology have introduced novel receptor tyrosine kinase inhibitors and immune checkpoint inhibitors for advanced renal cell carcinoma (aRCC).
- The clinical adoption and impact of these new treatments in Finland remained largely undocumented.
- Understanding treatment patterns is crucial for optimizing care for aRCC patients.
Purpose of the Study:
- To assess the utilization of systemic treatments for advanced renal cell carcinoma (aRCC) in Southwest Finland between 2010 and 2021.
- To evaluate the treatment outcomes, including overall survival (OS) and healthcare resource utilization, in relation to patient risk stratification.
- To analyze the adoption trends of novel therapies in routine clinical practice.
Main Methods:
- Retrospective analysis of electronic medical records for 1112 renal cell carcinoma (RCC) patients, with a focus on 336 diagnosed with aRCC.
- Patients were categorized based on the International Metastatic RCC Database Consortium (IMDC) risk classification.
- Data collected included clinical characteristics, systemic treatments received, healthcare resource utilization, and overall survival (OS).
Main Results:
- Of 336 aRCC patients, 57% received systemic treatment. First-line treatment shifted from sunitinib pre-2018 to a mix including cabozantinib and ipilimumab/nivolumab post-2018.
- Median OS varied significantly by IMDC risk: 61.9 months (favorable), 28.6 months (intermediate), and 8.1 months (poor).
- Second-line treatment uptake was lower in poor-risk patients (35%) compared to favorable (73%) and intermediate (74%) risk groups, with higher hospitalization rates in poor-risk patients.
Conclusions:
- Novel systemic treatments for aRCC were rapidly integrated into Finnish clinical practice following reimbursement.
- Overall survival and hospitalization needs are strongly correlated with the IMDC risk classification.
- Consideration of upfront combination therapies for poor-risk aRCC patients is recommended due to limited second-line treatment uptake.
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