Meeting
2023 ASCO Annual Meeting
Efficacy of first-line (1L) immunotherapy (IO)-based regimens in patients with sarcomatoid and/or rhabdoid (S/R) metastatic non-clear cell renal cell carcinoma (nccRCC): Results from the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC).
Authors
Chris Labaki
The Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA
Chris Labaki , Ziad Bakouny , Audreylie Lemelin , Matthew Scott Ernst , Kosuke Takemura , J Connor Wells , Sumanta Kumar Pal , Bernadett Szabados , Benoit Beuselinck , Rana R. McKay , Jae-Lyun Lee , Takeshi Yuasa , Francis Parnis , Georg A. Bjarnason , Bradley Alexander McGregor , David A. Braun , Wanling Xie , Wenxin Xu , Daniel Yick Chin Heng , Toni K. Choueiri
Organizations
The Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA, Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada, BC Cancer Agency, Vancouver, Canada, Calgary, AB, Canada, City of Hope, Duarte, CA, Barts Cancer Institute, London, United Kingdom, UZ Gasthuisberg - Katholieke University Leuven, Leuven, Belgium, University of California San Diego, La Jolla, CA, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan, Adelaide Cancer Center, Kurralta Park, Australia, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, School of Medicine, Yale University, New Haven, CT, Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, Dana-Farber Cancer Institute, Boston, MA
Research Funding
No funding received
None.
Background: Patients with advanced RCC with S/R components exhibit poor clinical outcomes. IO-based combination therapies demonstrated substantial efficacy among patients with metastatic S/R ccRCC, compared to VEGF targeted therapy (VEGF-TT). Recent trials showed promising activity of IO-based regimens in patients with advanced nccRCC. We sought to assess the efficacy of IO regimens among patients with S/R nccRCC. Methods: Patients with advanced nccRCC treated with 1L IO regimens (IO/IO or IO/VEGF-TT) or 1L VEGF-TT monotherapy (sunitinib or pazopanib) were included. Cases were categorized as S/R or non-S/R. The primary outcomes were overall survival (OS) and time to treatment failure (TTF) in patients with S/R nccRCC receiving 1L IO or VEGF-TT. Overall response rate (ORR) was a secondary outcome. OS and TTF were compared between groups (IO vs. VEGF-TT) using Cox regression models adjusted for age, IMDC risk groups, and nccRCC subtype. ORR was compared between groups (IO vs. VEGF-TT) using a logistic regression adjusted for the same confounders. Results: Overall, 103 patients with S/R nccRCC were included, of whom 33 (32%) received 1L IO regimens. Median follow-up was 31 months. After adjustment for confounding factors, patients with S/R nccRCC treated with IO regimens presented with significantly improved survival outcomes as compared to those receiving VEGF-TT (median OS [mOS]: NR vs. 7.1 and mTTF: 9.4 vs. 2.9 mos for IO regimens and VEGF-TT, respectively). Similarly, a higher ORR was seen in patients with S/R nccRCC receiving IO regimens versus VEGF-TT (34.1 vs. 10.9%, respectively). Among 430 patients with non-S/R nccRCC (IO regimens: n=44), no significant differences in survival outcomes between regimen classes were seen (mOS: 24.4 vs. 14.8 and mTTF: 4.2 vs. 5.0 mos for IO regimens and VEGF-TT, respectively). Conclusions: To our knowledge, this represents the largest effort to characterize the outcomes of patients with S/R nccRCC treated with IO regimens. Patients with S/R nccRCC appear to derive a substantial and selective benefit from IO regimens (vs. VEGF-TT). These data support the use of IO-based regimens in patients with S/R nccRCC.
| OS, TTF and ORR in patients with S/R and non-S/R nccRCC treated with 1L IO regimens vs. VEGF-TT. | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Median OS – IO regimens, mos (95%CI) | Median OS – VEGF-TT, mos (95%CI) | Adjusted HR (95%CI) | Median TTF – IO regimens, mos (95%CI) | Median TTF – VEGF-TT, mos (95%CI) | Adjusted HR (95%CI) | ORR – IO regimens, % | ORR – VEGF-TT, % | p-value* | |
| S/R nccRCC (N=103) | NR (19.3-NR) | 7.1 (3.9-13) | 0.25 (0.13-0.49) | 9.4 (2.8-NR) | 2.9 (2.2-4.3) | 0.34 (0.21-0.59) | 34.4 | 10.9 | 0.006 |
| Non-S/R nccRCC (N=430) | 24.4 (16.6-NR) | 14.8 (12.7-18.1) | 0.74 (0.46-1.21) | 4.2 (2.8-12.9) | 5.0 (4.4-5.7) | 1.20 (0.85-1.71) | 22.5 | 17.5 | 0.94 |
*Logistic regression.
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Details
Session Type
Poster Discussion Session
Session Title
Genitourinary Cancer—Kidney and Bladder
Track
Genitourinary Cancer—Kidney and Bladder
Sub Track
Kidney Cancer
Citation
J Clin Oncol 41, 2023 (suppl 16; abstr 4519)
DOI
10.1200/JCO.2023.41.16_suppl.4519
Abstract #
4519
Poster Bd #
11
Abstract Disclosures
Similar Abstracts
Abstract
2023 ASCO Genitourinary Cancers Symposium
Impact of number of treatment lines following first-line (1L) immuno-oncology (IO) combination on overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC).
First Author: Audreylie Lemelin
Abstract
2023 ASCO Genitourinary Cancers Symposium
Overall survival (OS) and efficacy results of second-line treatment in patients (pts) with metastatic clear cell renal cell carcinoma (mRCC) treated in the randomized phase II BIONIKK trial.
First Author: Yann-Alexandre Vano
Abstract
2023 ASCO Genitourinary Cancers Symposium
Overall survival (OS) and efficacy results of second-line treatment in patients (pts) with metastatic clear cell renal cell carcinoma (mRCC) treated in the randomized phase II BIONIKK trial.
First Author: Yann-Alexandre Vano
Abstract
2021 ASCO Annual Meeting
Combination of immunotherapy and tyrosine kinase inhibitor in first-line metastatic renal cell carcinoma: A real-world Indian experience.
First Author: Amit Rauthan