Photo Credit: Mohammed Haneefa Nizamudeen

The following is a summary of “Real-world clinical outcomes of patients with metastatic renal cell carcinoma receiving pembrolizumab + axitinib vs. ipilimumab + nivolumab,” published in the November 2023 issue of Urology by Shah, et al.

In the past few years, strong clinical study results on immuno-oncology (IO) medicines have changed the first-line (1L) treatment strategy for metastatic renal cell cancer (mRCC). For a study, researchers sought to look at how well people with clear cell mRCC (mccRCC) did after getting pembrolizumab+axitinib (pembro-axi) or ipilimumab+nivolumab (ipi-nivo) in a community cancer setting in the US. The US Oncology Network’s electronic health records and chart review were used to find adult patients with mccRCC who started 1L pembro-axi or ipi-nivo from January 1, 2019, to December 31, 2020, and were followed up until March 31, 2021. 

Responses recorded by doctors (real-world overall response rate [rwORR] and real-world disease control rate [rwDCR]) were looked at in a detailed way. Kaplan-Meier analysis was used to determine time on treatment (rwToT), time to next treatment (rwTTNT), and progression-free survival (rwPFS) in the real world.  Multivariable Cox proportional hazards models were used to examine the relationship between 1L systemic treatment and time-to-event outcomes. The study examined 331 people with mccRCC (44% were pembro-axi and 56% were ipi-nivo). Most of them were 65 years old, 75.5% were men, and 82.5% had an intermediate or poor (I/P) IMDC risk score. 

They found that rwORR and rwDCR for pembro-axi were 71.0% and 80.0%, and they were 45.2% and 58.6% for ipi-nivo. The pembro-axi group had longer rwToT (aHR, 0.53 [95% CI, 0.40–0.71]), rwTTNT (aHR, 0.60 [95% CI, 0.42–0.87]), and rwPFS (aHR, 0.70 [95% CI, 0.49–0.99]) than the ipi-nivo group (P < 0.01). The study gave them information about how well and how well tolerated novel mccRCC treatments work in the real world in the US. The fact that their real-world results were similar to data from clinical studies is good news for people with mccRCC.

Source: sciencedirect.com/science/article/abs/pii/S1078143923002855