Background: Metastatic renal cell carcinoma (mRCC) treatment avenues have expanded, yet Mexico’s fragmented healthcare system could impact real-world setting, scarce information is available, and little is known regarding this issue. This study aims to characterize the treatment patterns for mRCC in Mexico’s public and private healthcare sectors. Methods: De-identified patient data collected from 180 oncologists (03/2022 to 02/2023) using Evidera LiveTracker were assessed. Data from adult mRCC patients outside clinical study protocols were included. Patients were categorized by healthcare sectors, and line of treatment (L). A descriptive analysis was conducted. Results: Of 651 patients, 182 (28.0%) were favorable risk-stratified, 332 (51.0%) intermediate, and 137 (20.0%) high-risk. Treatment in 1L involved 542 (83.3%), 96 (14.7%) in 2L and 13 (2.0%) ≥3L. Sectors were evenly split: 327 (50.2%) public and 324 (49.8%) private. Among patients in 1L, 60.7% underwent TKI monotherapy (72.8% public vs 48.1% private) mainly with sunitinib (49.8%) and pazopanib (20.9%). Immunotherapy (IO) combination IO+IO was indicated in 26.2% (17.0% public vs 35.7% private), and IO+TKI in 7.9% (5.4% public vs 10.5% private). similar disparities trends were observed in 2L, where TKI monotherapy increased to 70.8% (84.5% public vs 58.8% private), whereas 21.9% (13.3% public vs 29.4% private) and 4.2% (2.2% public vs 5.9% private) received IO monotherapy and IO+TKI, respectively (Table). Conclusions: Despite clinical practice guidelines favoring the use of IO for mRCC 1L treatment, many Mexican patients receive currently TKI monotherapy, particularly in public healthcare, and this is consistent in subsequent lines of treatment. Potential access barriers warrant further exploration.

Residual percetages correspond to other treatments including VEGF, MTOR and non-pharmacological treatments.