Overall survival in renal cell carcinoma after introduction of targeted therapies: a Norwegian population-based study

Abstract

BackgroundThis population-wide retrospective, non-interventional registry study assessed changes in overall survival (OS) and factors influencing OS in Norwegian patients with renal cell carcinoma (RCC).MethodsTwo population-wide health registries were used to identify all RCC patients with (mRCC) or without metastases diagnosed before (2002–2005) and after (2006–2008 and 2009–2011) introduction of targeted therapies. Median OS was estimated using Kaplan–Meier method. Cox proportional hazards regression modeling was used to identify prognostic factors.ResultsOverall, 5,463 patients were diagnosed with RCC during 2002–2005 (n=1,898), 2006–2008 (n=1,631), and 2009–2011 (n=1,934); of these, 1,678 (31%) had mRCC. Patients diagnosed in 2009–2011 and 2006–2008 had significant (P<0.001) improvements in OS versus those diagnosed in 2002–2005: median OS, not reached and not reached versus 82.0 months in RCC; 14.0 and 12.0 months versus 9.0 months in mRCC. Similarly, OS improvements were seen in the primary and elderly (≥75 years) mRCC populations. Median OS was comparable (12 months) between clear cell and papillary mRCC, but it was longer (24.0 months) for chromophobe mRCC. Multivariate regression analyses showed that younger age, previous nephrectomy, and 1 or more prescriptions of targeted therapy were significantly associated with longer OS in mRCC patients.ConclusionOS increased in RCC and mRCC patients in Norway between 2002 and 2011 following introduction of targeted therapies.

Utilization and efficacy of second-line targeted therapy in metastatic renal cell carcinoma: data from a national registry

“…The proportion of patients who received second-line treatment (50.6%) in the present study is consistent with most previously published observations, such as the study of Levy et al (52%) and Beisland et al (45% of the 2011 cohort) [ 28 , 29 ]. In the largest, IMDC registry-based study of 2106 patients with the median follow-up of 36 months, 43% received second line therapy [ 30 ].…”

Changes in therapy and survival of metastatic renal cell carcinoma in Estonia

“…Novel drugs cabozantinib and immonotherapy drug nivolumab were shown to improve OS of mRCC patients after treatment failure with TKI-s [19,20]. According to more recent publication of phase Among national cohort studies of mRCC, there are 4 trials from Europe: Norwegian [15], Swedish [14] and Czech Republic [16] trial based on data from local registries and a Danish trial that used detailed and complete national data from medical records [13]. Our findings on the improvement of survival and treatment changes are comparable with those trials.…”

“…Danish Renal Cancer Group has evaluated the implementation of targeted therapy in a complete national cohort of patients, showing that this resulted in significantly improved treatment rates and overall survival [13]. Also, Swedish and Norwegian studies reported the contribution of targeted therapies to improved overall survival of mRCC patients [14,15]. Czech and Dutch studies have analyzed mRCC registry based data on targeted therapies use in their countries [16,17].…”

Biomarkers defining probability of receiving second-line targeted therapy in metastatic renal cell carcinoma

“…National cancer treatment programmes and/or drug prescription registries that cover the whole country populations provided data on new anti-mRCC therapies within real-life patients [ 8 , 9 ]. Currently, patients who receive second-line therapy are expected to reach median overall survival (OS) over 27 months, while those who are enrolled in three or more lines of treatment may obtain over 43 months of OS and are greatest beneficiaries of RCC targeted therapies (TT).…”