Almost Half of All Patients With mRCC Defer Frontline Systemic Therapy

MIAMI – A large percentage of real-world patients with metastatic renal cell carcinoma (mRCC) initially deferred systemic therapy despite various approved agents to treat the disease, a study presented at the 14^th International Kidney Cancer Symposium 2015 (IKCS 2015) has shown.

Although 7 agents were approved for the treatment of mRCC over the past decade, retrospective research has demonstrated that a significant proportion of patients may not receive systemic therapy in the first year after diagnosis with metastatic disease.

“This population is not represented in data from most retrospective and prospective series and the clinical trials literature,” Michael R. Harrison, MD, of Duke University Medical Center in Durham, NC, said during the poster presentation.

Therefore, researchers sought to evaluate contemporary patterns of care in the first 109 real-world patients enrolled in the Metastatic Renal Cell Cancer Registry (MaRcc).

Adult patients were eligible for inclusion if they had a diagnosis of mRCC with no prior systemic therapy for mRCC at study entry. Key exclusion criteria included active malignancies other than mRCC, unless all systemic therapy was completed at least 3 months prior to enrollment.

Researchers were able to analyze data from 109 patients with known systemic therapy status. Patients had a median age of 64 and were predominantly male. Clear cell histology was present in 87% of patients and 31% had stage 4 disease at diagnosis.

Results showed that 42.2% of patients deferred systemic therapy, 22.0% initiated pazopanib, 19.3% participated in a clinical trial, 11.0% initiated sunitinib, 1.8% initiated interleukin-2 and temsirolimus each, and 0.9% initiated bevacizumab and carboplatin each. Of the 82 patients treated at a U.S. academic site, 37.8% deferred systemic therapy, compared with 55.6% of the 27 who received treatment at community sites.

“As new therapies gain approval, MaRCC Registry will provide unique insights as to how these are integrated into management,” Dr. Harrison concluded.

Reference

1. Harrison MR, Bhavsar NA, Wolf SP, et al. Front-line management patterns in the prospective Metastatic Renal Cell Cancer (MaRCC) Registry [abstract]. BJU Int. 2015. doi: 10.1111/bju.13365.