ArticleTherapeutic advances in medical oncology2026
Patterns of first-line treatment selection in metastatic renal cell carcinoma: a real-world analysis from the Meet-URO 33-REGAL study.
Article in Therapeutic advances in medical oncology, 2026. 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
Background: Despite the availability of several first-line (1L) systemic therapies for metastatic renal cell carcinoma (mRCC), no validated biomarkers currently guide the selection of 1L systemic treatment. Objectives: To identify baseline clinical features associated with 1L treatment selection in a large real-world mRCC population. Design: Meet-URO 33-REGAL is a multicenter study with prospective and retrospective components, enrolling patients with mRCC receiving 1L systemic therapy since January 2021. Methods: Baseline patient and disease characteristics were analyzed to compare treatment selection among dual immune checkpoint inhibitor therapy (ICI-ICI), ICI plus tyrosine kinase inhibitor combinations (ICI-TKI), and TKI monotherapy. Multivariable logistic regression models were used to evaluate clinical features associated with pairwise treatment selection. Results: A total of 1695 patients from 58 centers were included: 248 (14.6%) received TKI monotherapy, 338 (20.0%) ICI-ICI, and 1109 (65.4%) ICI-TKI. ICI-ICI was more commonly selected in patients with sarcomatoid features (14.5% vs 7.4% for ICI-TKI, Conclusion: Meet-URO 33 provides a real-world snapshot of 1L decision-making in mRCC. Distinct clinical patterns, including histology, metastatic sites, performance status, comorbidities, and prognostic risk, were associated with treatment selection. These findings characterize clinical phenotypes in routine practice and provide context for future effectiveness, safety, and treatment-sequencing analyses of 1L therapeutic strategies within the Meet-URO 33 cohort over time.
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