Real-world Outcomes of Immunotherapy, Targeted Therapy for Metastatic pRCC

New research highlights real-world utilization trends of targeted therapy, immunotherapy, and immunotherapy plus targeted therapy combinations and their impact on overall survival (OS) for patients with metastatic papillary renal cell carcinoma (pRCC) with or without cytoreductive nephrectomy.

These associations were presented at the American Urological Association 2023 Annual Meeting.

Currently, the standard of care for patients with metastatic clear cell renal cell carcinoma is immunotherapy with or without targeted therapy. With the exception of a few phase 2, randomized clinical trials, the benefit of immunotherapy or immunotherapy plus targeted therapy combinations has not been thoroughly investigated in metastatic pRCC.

Carlos Riveros, MD, and colleagues queried the National Cancer Database to identify 73 adult patients with de novo metastatic pRCC who had received first-line targeted therapy (n=512), immunotherapy (n=126), or immunotherapy plus targeted therapy (n=99).

To evaluate the association between systemic therapy utilization and OS benefit, they performed a multivariable Cox proportional hazards regression analysis, with adjustment for receipt of cytoreductive nephrectomy and other covariates.

Researchers noted that the proportion of patients who received immunotherapy and immunotherapy plus targeted therapy combinations increased steadily during the study period.

After adjusting for baseline differences, cytoreductive nephrectomy was associated with a benefit in OS (hazard ratio [HR], 0.63; 95% CI, 0.49-0.84). However, they found that neither immunotherapy (HR, 1.10; 95% CI, 0.81-1.49) nor immunotherapy plus targeted therapy (HR, 0.83; 95% CI, 0.57-1.19) were associated with better OS than targeted therapy alone.