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Demographic Characteristics and Treatment Outcomes of Advanced Renal Cell Carcinoma With Clear Cell Histology: A
Somnath Roy1, Bivas Biswas1, Deepak Dabkara1
1Medical Oncology, Tata Medical Center, Kolkata, IND.
Abstract:
Background Treatment of metastatic renal cell cancer (mRCC) has revolutionized with the introduction of anti-VEGF tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs). There is limited data in the literature on the outcomes of Indian patients treated with TKI. Here, we report the outcome of mRCC treated with first-line TKI in a resource-poor setting. Material and methods This is a single-center retrospective study of clear cell mRCC treated with first-line TKI from June 2012 to December 2022. Demographic characteristics and treatment details, including outcome data, were captured from electronic medical records. Patients who received at least one week of therapy were eligible for survival analysis. Results A total of 345 patients with metastatic clear cell histology were analyzed, with a median age of 61 years (range: 20-84 years). One hundred and eighty patients (52%) underwent nephrectomy before systemic therapy. The majority received pazopanib (257 patients, 75%), followed by sunitinib (36 patients, 10%) and cabozantinib (21 patients, 6%); 145 (45%) patients required dose interruption, and 143 (43%) required dose modification of TKI for adverse events. After a median follow-up of 44 months, the median progression-free survival (PFS) was 20.3 months (95% CI: 17.8-24.8), and the median overall survival (OS) was 22.7 months (95% CI: 18.8-28.3). In the poor-risk International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) group, no prior nephrectomy emerged as an independent poor-risk factor for both PFS and OS in multivariate analysis. Conclusion This is the largest single-center cohort of clear cell mRCC from Asia. Median PFS was 20.3 months with predominantly TKI monotherapy. In the poor-risk IMDC group, no prior nephrectomy emerged as an independent poor-risk factor for both PFS and OS.
Insights
This study analyzed 345 Indian patients with metastatic renal cell cancer (mRCC) treated with first-line tyrosine kinase inhibitors (TKIs). Results show a median progression-free survival of 20.3 months, highlighting TKI effectiveness in a resource-poor setting.
Area of Science:
- Oncology
- Medical Research
- Clinical Outcomes
Background:
- Metastatic renal cell cancer (mRCC) treatment has advanced with anti-VEGF tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs).
- Limited data exists on outcomes for Indian patients receiving TKIs for mRCC.
- This study focuses on mRCC outcomes in a resource-poor Indian setting using first-line TKIs.
Purpose of the Study:
- To report the outcomes of Indian patients with clear cell mRCC treated with first-line TKIs.
- To evaluate progression-free survival (PFS) and overall survival (OS) in this patient cohort.
- To identify prognostic factors in the poor-risk International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) group.
Main Methods:
- A single-center retrospective study of 345 clear cell mRCC patients treated from June 2012 to December 2022.
- Data collected from electronic medical records, including demographics, treatment, and outcomes.
- Survival analysis was performed on patients receiving at least one week of TKI therapy.
Main Results:
- The median age of patients was 61 years; 52% underwent prior nephrectomy.
- Pazopanib was the most common TKI (75%), with 45% requiring dose interruption and 43% dose modification due to adverse events.
- Median PFS was 20.3 months and median OS was 22.7 months.
- In the poor-risk IMDC group, no prior nephrectomy was an independent poor-risk factor for PFS and OS.
Conclusions:
- This is the largest Asian single-center cohort of clear cell mRCC treated with TKIs.
- First-line TKI monotherapy demonstrated a median PFS of 20.3 months.
- Lack of prior nephrectomy is a significant poor-risk indicator for PFS and OS in the poor-risk IMDC mRCC subgroup.
