Real-world comparison of the efficacy of first-line therapies and the influence of risk factors in advanced renal cell carcinoma
Abstract Introduction Systemic therapy for advanced renal cell carcinoma (aRCC) has become increasingly diverse. In the 1st-line setting, various combination therapies are available, with little comparative data on the efficacy of the therapies. The aim of this study was to compare the current 1st-l...
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| Format: | Article |
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Springer
2025-03-01
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| Series: | Discover Oncology |
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| Online Access: | https://doi.org/10.1007/s12672-025-02131-z |
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| author | Maximilian Haack Stephanie Neuberger Jan Hendrik Boerner Stefanie Ziewers Gregor Duwe Robert Dotzauer Axel Haferkamp Rene Mager |
| author_facet | Maximilian Haack Stephanie Neuberger Jan Hendrik Boerner Stefanie Ziewers Gregor Duwe Robert Dotzauer Axel Haferkamp Rene Mager |
| author_sort | Maximilian Haack |
| collection | DOAJ |
| description | Abstract Introduction Systemic therapy for advanced renal cell carcinoma (aRCC) has become increasingly diverse. In the 1st-line setting, various combination therapies are available, with little comparative data on the efficacy of the therapies. The aim of this study was to compare the current 1st-line combination therapies under real-life conditions and to investigate risk factors in the patient population. Methods Patients with aRCC who started 1st-line IO/IO or IO/TKI combination therapy between 03/2019 and 10/2023 were included. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Secondary endpoints were time on treatment (ToT), duration of response (DoR), subsequent therapies, the evaluation of risk factors and their influence on PFS and OS. Survival data were analysed using Kaplan–Meier estimates with log-rank tests, risk factors for PFS and OS using Cox regression analysis. Results A total of 59 patients, mainly men (79.7%) with a median age of 64.8 years were included. The median follow-up was 21 months. The comparison of IO/IO vs. IO/TKI demonstrated a median PFS of 6 (2.08–9.92) vs. 14 (9.06–18.94) months (47 events; HR IO/TKI vs. IO/IO: 0.53 (0.29–0.99); p = 0.039) and a median OS of 20 (15.07–24.94) vs. 33 (21.68–44.32) months (32 deaths; HR IO/TKI vs. IO/IO: 0.74 (0.36–1.51); p = 0.403). Off all risk factors analysed only synchronous metastases proved to be of independent predictive value for PFS (HR 2.38; 95% CI 1.11–5.11; p = 0.026) and OS (HR 3.47; 95% CI 1.15–10.44; p = 0.027). Conclusion An IO/TKI therapy showed a significantly improved PFS in the real-world setting compared to an IO/IO combination. In terms of OS, the improved treatment response of the IO/TKI group did not prevail. |
| format | Article |
| id | doaj-art-e6449a76f1844e959890e3df7fc5536b |
| institution | DOAJ |
| issn | 2730-6011 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Springer |
| record_format | Article |
| series | Discover Oncology |
| spelling | doaj-art-e6449a76f1844e959890e3df7fc5536b2025-08-20T02:41:32ZengSpringerDiscover Oncology2730-60112025-03-0116111210.1007/s12672-025-02131-zReal-world comparison of the efficacy of first-line therapies and the influence of risk factors in advanced renal cell carcinomaMaximilian Haack0Stephanie Neuberger1Jan Hendrik Boerner2Stefanie Ziewers3Gregor Duwe4Robert Dotzauer5Axel Haferkamp6Rene Mager7Department of Urology and Pediatric Urology, Johannes Gutenberg University Medical CenterDepartment of Urology and Pediatric Urology, Johannes Gutenberg University Medical CenterDepartment of Urology and Pediatric Urology, Johannes Gutenberg University Medical CenterDepartment of Urology and Pediatric Urology, Johannes Gutenberg University Medical CenterDepartment of Urology and Pediatric Urology, Johannes Gutenberg University Medical CenterDepartment of Urology and Pediatric Urology, Johannes Gutenberg University Medical CenterDepartment of Urology and Pediatric Urology, Johannes Gutenberg University Medical CenterDepartment of Urology and Pediatric Urology, Johannes Gutenberg University Medical CenterAbstract Introduction Systemic therapy for advanced renal cell carcinoma (aRCC) has become increasingly diverse. In the 1st-line setting, various combination therapies are available, with little comparative data on the efficacy of the therapies. The aim of this study was to compare the current 1st-line combination therapies under real-life conditions and to investigate risk factors in the patient population. Methods Patients with aRCC who started 1st-line IO/IO or IO/TKI combination therapy between 03/2019 and 10/2023 were included. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Secondary endpoints were time on treatment (ToT), duration of response (DoR), subsequent therapies, the evaluation of risk factors and their influence on PFS and OS. Survival data were analysed using Kaplan–Meier estimates with log-rank tests, risk factors for PFS and OS using Cox regression analysis. Results A total of 59 patients, mainly men (79.7%) with a median age of 64.8 years were included. The median follow-up was 21 months. The comparison of IO/IO vs. IO/TKI demonstrated a median PFS of 6 (2.08–9.92) vs. 14 (9.06–18.94) months (47 events; HR IO/TKI vs. IO/IO: 0.53 (0.29–0.99); p = 0.039) and a median OS of 20 (15.07–24.94) vs. 33 (21.68–44.32) months (32 deaths; HR IO/TKI vs. IO/IO: 0.74 (0.36–1.51); p = 0.403). Off all risk factors analysed only synchronous metastases proved to be of independent predictive value for PFS (HR 2.38; 95% CI 1.11–5.11; p = 0.026) and OS (HR 3.47; 95% CI 1.15–10.44; p = 0.027). Conclusion An IO/TKI therapy showed a significantly improved PFS in the real-world setting compared to an IO/IO combination. In terms of OS, the improved treatment response of the IO/TKI group did not prevail.https://doi.org/10.1007/s12672-025-02131-zAdvanced renal cell carcinomaImmunotherapyTargeted therapyReal-world data |
| spellingShingle | Maximilian Haack Stephanie Neuberger Jan Hendrik Boerner Stefanie Ziewers Gregor Duwe Robert Dotzauer Axel Haferkamp Rene Mager Real-world comparison of the efficacy of first-line therapies and the influence of risk factors in advanced renal cell carcinoma Discover Oncology Advanced renal cell carcinoma Immunotherapy Targeted therapy Real-world data |
| title | Real-world comparison of the efficacy of first-line therapies and the influence of risk factors in advanced renal cell carcinoma |
| title_full | Real-world comparison of the efficacy of first-line therapies and the influence of risk factors in advanced renal cell carcinoma |
| title_fullStr | Real-world comparison of the efficacy of first-line therapies and the influence of risk factors in advanced renal cell carcinoma |
| title_full_unstemmed | Real-world comparison of the efficacy of first-line therapies and the influence of risk factors in advanced renal cell carcinoma |
| title_short | Real-world comparison of the efficacy of first-line therapies and the influence of risk factors in advanced renal cell carcinoma |
| title_sort | real world comparison of the efficacy of first line therapies and the influence of risk factors in advanced renal cell carcinoma |
| topic | Advanced renal cell carcinoma Immunotherapy Targeted therapy Real-world data |
| url | https://doi.org/10.1007/s12672-025-02131-z |
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