In a study of real-world treatment patterns, avelumab plus axitinib was being used across all International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) prognostic risk groups in patients with advanced renal cell carcinoma (aRCC), but few patients with poor risk were receiving the treatment. The research was presented at the International Kidney Cancer Symposium (IKCS) 2021.

First-line avelumab plus axitinib to treat patients with aRCC was approved by the US Food and Drug Administration (FDA) in 2019. To gain insights into patient characteristics and outcomes in the real-world setting, the investigators examined treatment patterns and durations in patients with aRCC across the IMDC risk status spectrum who received first-line avelumab plus axitinib.

They obtained data using a point-in-time survey administered to physicians (27 physicians; 20 oncologists, 4 nephrologists, and 3 urologists) in the United States between October 2020 and February 2021. Participating physicians abstracted data for their next 8 consecutively consulting adult patients with aRCC. Data from patients who received first-line avelumab plus axitinib for 3 months or more were further analyzed in the study.

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In total, 158 patients with aRCC received consultation. Of those, 143 patients received first-line avelumab plus axitinib. These patients (68% male) had a mean age of 64.8±9.0 years. Most patients had Eastern Cooperative Oncology Group performance status of 0 to 1 (60%) and IMDC intermediate- or poor-risk disease (65% and 4%, respectively). However, 23% of patients had unknown or not-assessed IMDC prognostic score.

According to physician-reported treatment response data, 42% of patients had a complete response (15%) or partial response (27%). The other patients were reported as having stable disease (32%), progressive disease (5%), clinical relapse (3%), relapse from CR (1%), or were reported as unable to determine or not reported (17%). The median duration of treatment was 5.0 months (interquartile range, 4.0-6.0).

The most commonly reported reason that patients stopped first-line avelumab plus axitinib treatment was disease progression (13 patients). No patients were reported as discontinuing treatment due to unacceptable tolerability or adverse events.

Limitations of the study included potential selection bias, exclusion of physicians who see less than 5 patients with aRCC per month, no formal patient selection verification procedures in place, potential recall bias, and lack of verification of data against the primary source. The investigators noted that all first-line patients were receiving ongoing treatment, explaining the limited duration of therapy.

“These findings provided important insights into the patient characteristics and related outcomes in a heterogeneous patient population with aRCC treated with 1L avelumab + axitinib, including patients who would not be eligible for clinical trials,” the investigators concluded. “Additional research may enhance understanding of treatment patterns and sequencing within the first 2 treatment lines in patients with aRCC.”

Disclosure: This research was sponsored by Pfizer, as part of an alliance between Pfizer and the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945). Please see the original reference for a full list of authors’ disclosures.


Zanotti G, Ribbands A, Leith A, Last M, Forshaw C, Liu FX, Kearney M. Real-world clinical characteristics and treatment patterns of patients with advanced renal cell carcinoma treated with first-line avelumab + axitinib in the United States. Presented at IKCS 2021; November 5-6, 2021. Abstract N23.