Real-World Symptoms, Disease Burden, Resource Use and Quality of Life in US Patients with Advanced Renal Cell Cancer

Hall, J.; Zanotti, Giovanni; Kim, Ruth; Krulewicz, Stan; Leith, Andrea; Bailey, Abigail; Liu, Frank X.; Kearney, Mairead

doi:10.2217/fon-2020-1266

Cited by 4 publications

(4 citation statements)

References 34 publications

(41 reference statements)

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“…Few studies have been published detailing HCRU among patients with mRCC in LOT1. One study used the US point-in-time survey and reported a mean of 0.2 hospitalizations over the past 6 months in patients treated with IO-IO combinations. We observed a similar mean unadjusted PPPM for IP stays of 0.2 in the I+N group for the full follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Health Care Resource Use for Modern First-Line Treatments in Metastatic Renal Cell Carcinoma

Shah,

Shinde,

Moore

et al. 2024

JAMA Netw Open

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ImportanceImmuno-oncology agents have changed the treatment paradigm for metastatic renal cell carcinoma (mRCC). Such therapies improve survival but can impose considerable health care resource use (HCRU) and associated costs, necessitating their examination.ObjectiveTo compare HCRU, costs, and clinical outcomes among patients receiving first-line pembrolizumab plus axitinib (P+A) or ipilimumab plus nivolumab (I+N).Design, Setting, and ParticipantsThis retrospective cohort study used data from an administrative claims database on patients with mRCC receiving first-line P+A or I+N that was initiated between January 2018 and May 2020. Data were analyzed from February 2021 to July 2022.ExposureFirst-line P+A or I+N.Main Outcome and MeasuresHCRU and costs during the first 90 days, full first-line treatment, and full follow-up periods were assessed. Using Kaplan-Meier analysis, time on treatment, overall survival, time to first emergency department (ED) visit, and time to first inpatient stay were compared.ResultsAmong 507 patients, there were 126 patients receiving P+A (91 male [72.2%]; mean [SD] age, 67.93 [9.66] y) and 381 patients receiving I+N (271 male [71.1%]; mean [SD] age, 66.52 [9.94] years). The median time on treatment was longer for the P+A compared with I+N group (12.4 months [95% CI, 8.40 months to not estimable] vs 4.1 months [95% CI, 3.07 to 5.30 months]; P &lt; .001). The median time to first ED visit was longer for the P+A than I+N group (7.2 months [95% CI 3.9 to 11.1 months ] vs 3.3 months [95% CI, 2.6 to 3.9 months]; P = .005), as was time to first inpatient stay (9.0 months [95% CI 6.5 months to not estimable] vs 5.6 months [95% CI, 3.9 to 7.9 months]; P = .02). During the first 90 days, a lower proportion of the P+A than N+I group had ED visits (43 patients [34.1%] vs 182 patients [47.8%] and inpatient stays (24 patients [19.1%) vs144 patients [37.8%]; P &lt; .001). During full follow-up, mean total adjusted costs were similar for P+A and I+N groups, but adjusted 12-month estimated total costs were higher for P+A than I+N groups ($325 574 vs $ 263 803; P = .03).Conclusions and RelevanceIn this study, treatment with P+A was associated with longer time on treatment, time to first ED visit, and inpatient stay, while 12-month estimated costs were higher for the P+A group. This is among the first clinical studies to evaluate economic burden associated with modern treatments for mRCC.

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Section: Discussionmentioning

confidence: 99%

Health Care Resource Use for Modern First-Line Treatments in Metastatic Renal Cell Carcinoma

Shah,

Shinde,

Moore

et al. 2024

JAMA Netw Open

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“…In the present study, the IMDC risk category could not be defined for 11% of the patients, while a previous RWE study conducted in the United States could not define the risk category for 40% of the patients. 12 RWE studies in the UK 13 and Norway 14 have highlighted improvements in the OS of aRCC patients with the introduction of targeted therapies. However, the absence of established prognostic factors, such as the IMDC risk category, in RWE studies does not provide details on OS according to risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, Hall et al reported no association of IMDC risk category with hospitalization frequency – although their window of a 6-month data capture prior to treatment start may have affected this result. 12 …”

Section: Discussionmentioning

confidence: 99%

Observational study on the evolution of systemic treatments for advanced renal cell carcinoma in Southwest Finland between 2010 and 2021

Hölsä,

Teittinen,

Anttalainen

et al. 2023

Therapeutic Advances in Urology

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Background: Novel receptor tyrosine kinase inhibitors and immune checkpoint inhibitors have been introduced to the treatment of advanced renal cell carcinoma (aRCC) during the past decade. However, the adoption of novel treatments into clinical practice has been unknown in Finland. Objectives: Our aim was to evaluate the use of systemic treatments and treatment outcomes of aRCC patients in Southwest Finland during 2010–2021. Design and Methods: Clinical characteristics, treatments for aRCC, healthcare resource utilization, and overall survival (OS) were retrospectively obtained from electronic medical records. Patients were stratified using the International Metastatic RCC Database Consortium (IMDC) risk classification. Results: In total, 1112 RCC patients were identified, 336 (30%) patients presented with aRCC, and 57% of them ( n = 191) had received systemic treatment. Pre-2018, sunitinib (79%) was the most common first-line treatment, and pazopanib (17%), axitinib (17%), and cabozantinib (5%) were frequently used in the second-line. Post-2018, sunitinib (52%), cabozantinib (31%), and the combination of ipilimumab and nivolumab (10%) were most commonly used in the first-line, and cabozantinib (23%) in the second-line. Median OS for patients with favorable, intermediate, and poor risk were 61.9, 28.6, and 8.1 months, respectively. A total of 73%, 74%, and 35% of the patients with favorable, intermediate, and poor risk had received second-line systemic treatment. In poor-risk patients, the number of hospital inpatient days was twofold higher compared to intermediate and fourfold higher compared to favorable-risk patients. Conclusion: New treatment options were readily adopted into routine clinical practice after becoming reimbursed in Finland. OS and the need for hospitalization depended significantly on the IMDC risk category. Upfront combination treatments are warranted for poor-risk patients as the proportion of patients receiving second-line treatment is low. Registration: Clinical trial identifier: ClinicalTrials.gov NCT05363072.

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“…However, when the cancer progresses and becomes metastatic, the median survival drops to 55.7 months [ 6 ]. Tumor progression and metastasis have a strong impact on patient survival and the quality of life of kidney cancer patients [ 7 , 8 ]. The mechanisms by which tumors grow and disseminate in the body are not completely elucidated, but large extracellular vesicles (lEVs) may play a key role.…”

Section: Introductionmentioning

confidence: 99%

Effects of Large Extracellular Vesicles from Kidney Cancer Patients on the Growth and Environment of Renal Cell Carcinoma Xenografts in a Mouse Model

Ferragu

Vergori

Corre

et al. 2023

CIMB

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Plasma membrane-derived vesicles, also referred to as large extracellular vesicles (lEVs), are implicated in several pathophysiological situations, including cancer. However, to date, no studies have evaluated the effects of lEVs isolated from patients with renal cancer on the development of their tumors. In this study, we investigated the effects of three types of lEVs on the growth and peritumoral environment of xenograft clear cell renal cell carcinoma in a mouse model. Xenograft cancer cells were derived from patients’ nephrectomy specimens. Three types of lEVs were obtained from pre-nephrectomy patient blood (cEV), the supernatant of primary cancer cell culture (sEV) and from blood from individuals with no medical history of cancer (iEV). Xenograft volume was measured after nine weeks of growth. Xenografts were then removed, and the expression of CD31 and Ki67 were evaluated. We also measured the expression of MMP2 and Ca9 in the native mouse kidney. lEVs from kidney cancer patients (cEV and sEV) tend to increase the size of xenografts, a factor that is related to an increase in vascularization and tumor cell proliferation. cEV also altered organs that were distant from the xenograft. These results suggest that lEVs in cancer patients are involved in both tumor growth and cancer progression.

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Real-World Symptoms, Disease Burden, Resource Use and Quality of Life in US Patients with Advanced Renal Cell Cancer

Cited by 4 publications

References 34 publications

Health Care Resource Use for Modern First-Line Treatments in Metastatic Renal Cell Carcinoma

Health Care Resource Use for Modern First-Line Treatments in Metastatic Renal Cell Carcinoma

Observational study on the evolution of systemic treatments for advanced renal cell carcinoma in Southwest Finland between 2010 and 2021

Effects of Large Extracellular Vesicles from Kidney Cancer Patients on the Growth and Environment of Renal Cell Carcinoma Xenografts in a Mouse Model

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