Immune checkpoint inhibitor (ICI) therapy may improve survival outcomes compared with tyrosine kinase inhibitor (TKI) therapy among patients undergoing cytoreductive nephrectomy for metastatic renal cell carcinoma (mRCC), investigators reported at the American Urological Association’s 2022 annual meeting in New Orleans, Louisiana.
Using the REMARCC (REgistry of MetAstatic RCC) database, Margaret Meagher, MD, of the University of California, San Diego, and colleagues performed a retrospective analysis of 189 patients who underwent cytoreductive nephrectomy. The investigators divided the cohort into those who received TKIs (149 patients) vs ICIs (40 patients) as first-line therapy. They observed no differences between the groups with respect to age, sex, number of metastases at diagnosis, or baseline ECOG performance status. The groups also did not differ with respect to receipt of neoadjuvant or adjuvant therapy.
Multivariable analysis revealed that an increasing number of metastases at diagnosis independently increased the risk for all-cause mortality (ACM) and cancer-specific mortality, Dr Meagher reported. ICI therapy was significantly associated with a 59% decreased risk for ACM compared with TKI therapy. Compared with TKI recipients, patients treated with ICIs had significantly greater 5-year overall survival (51% vs 22%) and 5-year cancer-specific survival (82% vs 36%).
Results also showed that worse ECOG status at diagnosis was independently associated with an increased risk for cancer recurrence.
Meagher M, Minervini A, Mir M, et al. Cytoreductive nephrectomy in patients receiving TKI therapy versus checkpoint inhibitor therapy: Analysis of the REMARCC registry. Presented at AUA 2022, May 13-16, 2022, New Orleans, Louisiana. Abstract PD18-01.