|The following article features coverage from the 2020 Genitourinary Cancers Symposium meeting. Click here to read more of Renal and Urology News’ conference coverage.|
SAN FRANCISCO—Patients with intermediate-risk metastatic renal cell carcinoma (mRCC) appear to have divergent outcomes depending on whether they have 1 vs 2 risk factors, according to new data presented at the 2020 Genitourinary Cancers Symposium.
Using the German multicenter registry, STAR-TOR, investigators examined outcomes for more than 300 patients with mRCC treated with sunitinib according to risk groups defined by both the International Metastatic RCC Database Consortium (IMDC) and the Memorial Sloan-Kettering Cancer Center/Motzer (MSKCC/Motzer) model. Patients with 0, 1 to 2, or 3 or more risk factors are considered to have favorable-, intermediate-, or high-risk disease, respectively.
According to IMDC or MSKCC/Motzer, 16.7% and 15.3%, 26.2% and 30.8%, 18.7% and 24.7%, and 38.5% and 29.2% of patients had 0, 1, 2, or 3 or more risk factors, respectively. Among IMDC intermediate-risk patients, the most common risk factor (experienced by 24.8%) was an interval between diagnosis and therapy of less than 1 year. Among MSKCC/Motzer intermediate-risk patients, the most common risk factors were less than 1 year between diagnosis and therapy along with low hemoglobin (19.9%) and low hemoglobin alone (18.7%).
Overall survival (but not progression-free survival) was significantly longer for patients with 1 vs 2 risk factors using either IMDC or MSKCC/Motzer criteria.
“Overall survival for patients with 1 risk factor may align with the favorable risk group, whereas patients with 2 risk factors may align with the poor-risk group,” Michael Moran, MD, PhD, MRCS, of Pfizer told Renal & Urology News. “Sunitinib was most effective in patients with favorable risk.”
Objective response rate generally varied by number of risk factors. In the IMDC model (but not MSKCC/Motzer), patients with 1 vs 2 risk factors had a higher objective response: 41.9% vs 29.5%.
“Further investigation of how patients are stratified is needed to optimize treatment selection and potentially clinical outcomes,” Dr Moran stated. “It will be interesting to see if these findings in the renal cell carcinoma monotherapy setting translate across to the immune-oncology/tyrosine kinase inhibitor combination therapy landscape.”
Disclosure: This clinical trial was supported by Pfizer. Please see the original reference for a full list of authors’ disclosures.
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Moran M, Hubbe M, Rink R, et al. Real-world outcomes in patients with metastatic renal cell carcinoma according to risk factors: Analysis of the STAR TOR registry. Paper presented at the 2020 Genitourinary Cancers Symposium held February 13 to 15 in San Francisco. Abstract 628.