Treatment Characteristics, Survival Rates, and Costs of IO/IO and IO/TKI Therapies for mRCC

The use of tyrosine kinase inhibitors (TKIs), immuno-oncology (IO) therapies, and other treatments in recent years has led to positive growth of the metastatic renal cell carcinoma (mRCC) treatment landscape.

As the field continues to grow, researchers have conducted a real-world study to determine the impact of treatment patterns and costs for patients with mRCC through the use of integrated claims and clinical information.

The retrospective cohort study utilized integrated claims and clinical data obtained from a commercial health plan to examine costs of treatment for  adult patients with mRCC who began first-line (1L) treatment between April 2018 and January 2023.

Patient characteristics, treatment patterns, health care resource utilization (HCRU), costs, and survival were examined for patients who received 1L IO + IO or IO + TKI combinations. First- and second-line (2L) regimens and HCRU were also described.

Costs were summarized per patient per month over time. Survival time was analyzed overall and partitioned into duration of 1L treatment, treatment-free survival, and survival after 2L treatment.

Patients who received 1L IO + IO (n=471) or IO + TKI (n=353) treatments were found to have similar baseline characteristics. However, among patients with risk data available, 33% of patients treated with IO + IO had poor risk scores compared with 23% of patients treated with IO + TKI.

For patients who received IO + IO, treatment costs were higher during the first three months but lower in subsequent time intervals compared with patients who received IO + TKI. The total mean costs per patient were $720K and $834K for IO + IO and IO + TKI, respectively, over the course of three years.

Medication represented 80% of total costs. Patients receiving IO + IO continued 1L therapy for a shorter amount of time, but the cumulative survival time at 24 months was the same for both groups at 63%.

Patients who received 1L IO + IO and IO + TKI treatments had similar baseline characteristics and similar survival rates at 30 months. Although IO + IO treatment is linked to higher costs during the first three months of treatment, subsequent monthly costs are lower compared with IO + TKI treatments.