ArticleInternational journal of clinical oncology2025
Trends in real-world outcomes of patients with metastatic renal cell cancer in the recent treatment era: a single-institution analysis.
Article in International journal of clinical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSystemic therapy for metastatic renal cell cancer (mRCC) has changed significantly due to randomized controlled trial results. We investigated whether these changes affect real-world outcomes and clarified factors associated with treatment outcomes in patients from a single institution outside of clinical trials.
methodsWe retrospectively reviewed records of mRCC patients treated at Osaka International Cancer Institute between January 2005 and May 2024. Between-group analysis of progression-free survival (PFS) and overall survival (OS) by Kaplan-Meier comparison and identification of survival-associated factors by univariate and multivariate analyses were performed. Patients assumed ineligible for clinical trials were analyzed in subgroups according to any of Eastern Cooperative Oncology Group performance status > 1, hemoglobin level < 9.0 g/dL, estimated glomerular filtration rate < 40 mL/min/1.73 m
resultsIn total, 320 patients were evaluated: 2005-2009, n = 58; 2010-2014, n = 77; 2015‒2019, n = 86; and 2020‒2024, n = 99. Significant between-group differences were observed for median PFS (7 vs. 8 vs. 12 vs. 20 months; p = 0.0048) and (35 vs. 38 vs. 67 vs. 52 months; p = 0.0206). Multivariate analysis revealed that first-line or subsequent-line immune checkpoint inhibitor (ICI) use was an independent factor for OS (HR: 0.28, p < 0.0001). Even among 112 (35%) trial-ineligible patients, multivariate analysis demonstrated that the use of first-line or subsequent-line ICI was an independent factor for OS (HR: 0.26, p < 0.0001).
conclusionOver time, treatment outcomes appeared to have improved with real-world treatment for mRCC, with use of ICIs being related to improvements in treatment outcomes.
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