Postimmunotherapy and Vascular Endothelial Growth Factor Inhibitor Landscape in Advanced Renal Cell Carcinoma:...

With more patients with metastatic renal cell carcinoma (mRCC) receiving immuno-oncology (IO) and vascular endothelial growth factor (VEGF)-targeted therapies, understanding treatment patterns and outcomes following these therapies is essential. To describe patient characteristics, treatment patterns, and health care resource use (HCRU) among patients with mRCC with previous receipt of IO- and VEGF-based therapies.

This retrospective cohort study identified adults in Optum's Clinformatics Data Mart Database who were diagnosed with mRCC from August 2015 through July 2022 and received subsequent therapies after IO- and VEGF-based therapies. Patients were classified by the first line of treatment that they received after exposure to IO- and VEGF-based therapies. Outcomes included treatment patterns (time on treatment [ToT], time to next treatment [TTNT]), HCRU, and costs.

We identified 664 patients with mRCC with previous receipt of IO- and VEGF-based therapies (2L cohort: 186 patients, 3L cohort: 429 patients, 4L cohort: 49 patients). Cohorts were similar in terms of age (median 66-69 years), gender (72.0%-75.5% male), and race (63.3%-68.8% White). The median ToT was 4.4, 5.0, and 5.6 months and the median TTNT was 10.7, 11.7, and 9.5 months for 2L, 3L, and 4L cohorts, respectively. The HCRU increased by progressive lines of therapy (LOT), including inpatient hospital admissions (22.0%, 27.7%, and 32.7%) and emergency visits (26.9%, 30.3%, and 32.7%). The total cost across cohorts was $23,605 per patient per month.

Our study provides a comprehensive evaluation of clinical and economic impacts of therapies administered to patients with mRCC after IO- and VEGF-based therapies. It highlights a need for novel, cost-effective treatments and studies examining patient out-of-pocket costs.