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Do Trial Findings Translate to Real-World Treatment Success in Metastatic Kidney Cancer?

By: Celeste L. Dixon
Posted: Monday, June 21, 2021

Broader real-world applicability beyond the clinical trial setting has been demonstrated for first-line immunotherapy-based regimens compared with targeted therapy alone in patients with metastatic clear cell renal cell carcinoma, reported Brandon J. Manley, MD, of Moffitt Cancer Center in Tampa, Florida, and colleagues in JAMA Network Open. Among 5,872 patients included in the propensity-matched cohort study of the therapies, those treated with either immunotherapy or combination immunotherapy/targeted therapy in the first-line setting experienced better overall survival than those who received initial targeted therapy alone. No significant overall survival difference was noted between the immunotherapy-alone and immunotherapy/targeted therapy groups.

The data from the study patients, who were treated between January 1, 2015, and December 31, 2017, were gleaned from the National Cancer Database for this retrospective propensity-matched cohort study, the authors explained. The median age of all patients was 64 years; about 70% were men, and 81% received initial targeted therapy alone.

“Highlighting the expansion of combination immunotherapy/targeted therapy options available as first-line agents for [these patients], the results from two clinical trials have been reported in the brief time since this article was initially prepared. Lenvatinib plus pembrolizumab and nivolumab plus cabozantinib combinations have both demonstrated significantly improved overall survival compared with sunitinib alone,” Dr. Manley and co-investigators noted.

Even within the timespan of the data they analyzed, initial treatment with either immunotherapy or combination immunotherapy/targeted therapy was on the rise: 15% in 2015, 18% in 2016, and 24% in 2017. And now, “there is a wide array of highly effective options currently available in this disease setting,” the team concluded.

Disclosure: The study authors’ disclosure information can be found at jamanetwork.com.



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