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Updated: Jun 19, 2025
06:38
A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
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Health Care Resource Use for Modern First-Line Treatments in Metastatic Renal Cell Carcinoma
Neil J Shah1, Reshma Shinde2, Kristin J Moore3
1Memorial Sloan Kettering Cancer Center, New York, New York.
JAMA Network Open
|July 25, 2024
Summary
Pembrolizumab plus axitinib (P+A) treatment for metastatic renal cell carcinoma (mRCC) showed longer treatment duration and fewer emergency visits than ipilimumab plus nivolumab (I+N). However, P+A incurred higher 12-month costs, highlighting the economic trade-offs of advanced mRCC therapies.
Area of Science:
- Oncology
- Health Economics
- Pharmacoeconomics
Background:
- Immuno-oncology agents have transformed metastatic renal cell carcinoma (mRCC) treatment, improving survival.
- These advanced therapies present significant healthcare resource utilization (HCRU) and cost implications.
- Evaluating the economic burden of first-line mRCC treatments is crucial for resource allocation.
Purpose of the Study:
- To compare HCRU, costs, and clinical outcomes between first-line pembrolizumab plus axitinib (P+A) and ipilimumab plus nivolumab (I+N) in mRCC patients.
- To assess the economic impact and clinical effectiveness of these distinct immuno-oncology regimens.
Main Methods:
- Retrospective cohort study utilizing an administrative claims database.
- Inclusion of mRCC patients receiving first-line P+A or I+N between January 2018 and May 2020.
- Analysis of HCRU, costs (90-day, full treatment, full follow-up), time on treatment, overall survival, and time to emergency department (ED) visits and inpatient stays.
Main Results:
- Patients receiving P+A demonstrated significantly longer median time on treatment (12.4 vs. 4.1 months), time to first ED visit (7.2 vs. 3.3 months), and time to first inpatient stay (9.0 vs. 5.6 months) compared to I+N.
- The P+A group had a lower proportion of ED visits and inpatient stays within the first 90 days (34.1% vs. 47.8% and 19.1% vs. 37.8%, respectively).
- While mean total adjusted costs were similar across full follow-up, adjusted 12-month estimated total costs were higher for P+A ($325,574) versus I+N ($263,803).
Conclusions:
- First-line P+A in mRCC is associated with improved clinical outcomes, including longer treatment duration and delayed healthcare utilization.
- Despite clinical benefits, P+A is linked to higher 12-month healthcare costs compared to I+N.
- This study provides critical insights into the economic burden of modern first-line immuno-oncology treatments for mRCC.
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