To date, limited studies have examined heterogeneity in the IR group. This study assessed patient characteristics and clinical heterogeneity among mRCC patients in the IMDC IR group who received first-line sunitinib therapy in the real-world setting. Methods: Clear cell mRCC patients classified as IR who initiated sunitinib as first-line therapy in 2010-2018 were included in this retrospective analysis. Median overall survival (OS) and median time to treatment discontinuation (TTD) from sunitinib initiation was estimated using Kaplan-Meier analysis. Results: Among patients classified as IR (n=885), the most common risk factors were ,1 year from diagnosis to treatment (65%) and anemia (50%). There were 458 and 427 pts in the IMDC IR group who had 1 vs 2 risk factors, respectively. Patients with 1 vs 2 risk factors had significantly lower proportion of brain metastases (8.3% vs 13.5%, P=0.03) and bone metastases (32.3% vs 41.9%, P,0.01), and higher proportion of prior nephrectomy (91.7% vs 81.5%, P,0.01) and prior IL-2/IFN therapy (5.7% vs 2.1%, P,0.01). For patients with 1 vs 2 risk factors, the median OS (95% CI) was 35.
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