Access to treatment among patients with advanced kidney cancer in Mexico

Abstract

Objectives: In many cases, the socioeconomic status of patients diagnosed with metastatic renal cell carcinoma (mRCC) in developing countries could limit their access to the best available therapeutic options. We aimed to describe the clinical characteristics and access to treatment of Mexican patients with mRCC. Materials and methods: We performed a retrospective analysis of all patients with a histopathologically confirmed diagnosis of renal cell carcinoma treated at an oncology referral center in Northeast Mexico over a 5-year period. Results: We included 233 patients in the analysis, of whom 63% were men. The mean age at diagnosis was 58.2 years; 87% of the tumors were histopathologically classified as clear cell carcinoma. Regarding laterality, 54% of the tumors originated from the right kidney. The distribution of cases by clinical stage (CS) was as follows: CS I 15%, CS II 8%, CS III 17%, and CS IV 60%. In terms of access to first-line systemic management in the 139 patients with advanced kidney cancer who were candidates for treatment, 29% received treatment with a single-drug tyrosine kinase inhibitor (TKI), 4% were treated with combined or single-drug immunotherapy (IO), and 12% were treated with TKI combined with IO. Fifty-five percentages of patients with the advanced disease did not have access to standard first-line therapy, and the rate of loss to medical follow-up was 69% of cases. Conclusions: Despite the proven oncological benefit of the latest generation of therapies based on IO/IO or IO/TKI for mRCC, access to first-line standard management is still poor in our country.