Immunotherapy in metastatic renal cell carcinoma: Insights from a Dutch nationwide cohort
Targeted therapy with tyrosine kinase inhibitors (TKIs) was the standard of care for metastatic renal cell carcinoma (mRCC) until recently, when new first-line combinations with immuno-oncology (IO) agents were approved. We evaluated IO uptake in both first-line and later-line treatment in routine c...
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Elsevier
2025-02-01
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| Series: | European Urology Open Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666168325000503 |
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| author | Hilin Yildirim Anke Richters Adriaan D. Bins Arnoud W. Postema Maureen J.B. Aarts Martijn G.H. van Oijen Patricia J. Zondervan Katja K.H. Aben |
| author_facet | Hilin Yildirim Anke Richters Adriaan D. Bins Arnoud W. Postema Maureen J.B. Aarts Martijn G.H. van Oijen Patricia J. Zondervan Katja K.H. Aben |
| author_sort | Hilin Yildirim |
| collection | DOAJ |
| description | Targeted therapy with tyrosine kinase inhibitors (TKIs) was the standard of care for metastatic renal cell carcinoma (mRCC) until recently, when new first-line combinations with immuno-oncology (IO) agents were approved. We evaluated IO uptake in both first-line and later-line treatment in routine clinical practice in the Netherlands. Patients diagnosed with synchronous mRCC between 2018 and 2022 were identified from the population-based Netherlands Cancer Registry (n = 2621). The median age was 70 yr and 58% of patients had clear-cell RCC. Overall, 55% received at least one line of systemic therapy, 7% underwent cytoreductive nephrectomy without systemic therapy, and the remaining 37% received best supportive care. In the systemic treatment cohort, first-line TKI use decreased from 94% in 2018 to 21% in 2022, while IO use increased from 6% to 79%. Data from 2019–2020 show that 32% and 10% of patients received any second-line and third-line therapy, respectively. The 3-yr overall survival rate for patients with synchronous mRCC increased from 20% (95% confidence interval [CI] 16–23%) in 2018 to 28% in 2021 (95% CI 24–33%). Our analysis shows that IO approvals for mRCC since 2019 have led to an immediate and large increase in IO use to approximately 80% of patients who receive systemic treatment. Patient summary: Since 2019, systemic treatments for metastatic kidney cancer have shifted from drugs targeting selected proteins to immunotherapy. Our results show trends over time for more favorable characteristics among patients receiving systemic treatment and improvements in survival. |
| format | Article |
| id | doaj-art-3b74fdf575954ed39c618bf1b41f33f4 |
| institution | Kabale University |
| issn | 2666-1683 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj-art-3b74fdf575954ed39c618bf1b41f33f42025-02-12T05:32:50ZengElsevierEuropean Urology Open Science2666-16832025-02-01724245Immunotherapy in metastatic renal cell carcinoma: Insights from a Dutch nationwide cohortHilin Yildirim0Anke Richters1Adriaan D. Bins2Arnoud W. Postema3Maureen J.B. Aarts4Martijn G.H. van Oijen5Patricia J. Zondervan6Katja K.H. Aben7Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands; Corresponding author. Amsterdam UMC, Locatie VU Medisch Centrum, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Tel. +31 20 4446030; Fax: +31 20 4446031.Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, The NetherlandsDepartment of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Urology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Medical Oncology, GROW-School for Oncology and Reproduction, Maastricht University Medical Centre, Maastricht, The NetherlandsDepartment of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands; Science Department, IQ Health, Radboud University Medical Centre, Nijmegen, The NetherlandsTargeted therapy with tyrosine kinase inhibitors (TKIs) was the standard of care for metastatic renal cell carcinoma (mRCC) until recently, when new first-line combinations with immuno-oncology (IO) agents were approved. We evaluated IO uptake in both first-line and later-line treatment in routine clinical practice in the Netherlands. Patients diagnosed with synchronous mRCC between 2018 and 2022 were identified from the population-based Netherlands Cancer Registry (n = 2621). The median age was 70 yr and 58% of patients had clear-cell RCC. Overall, 55% received at least one line of systemic therapy, 7% underwent cytoreductive nephrectomy without systemic therapy, and the remaining 37% received best supportive care. In the systemic treatment cohort, first-line TKI use decreased from 94% in 2018 to 21% in 2022, while IO use increased from 6% to 79%. Data from 2019–2020 show that 32% and 10% of patients received any second-line and third-line therapy, respectively. The 3-yr overall survival rate for patients with synchronous mRCC increased from 20% (95% confidence interval [CI] 16–23%) in 2018 to 28% in 2021 (95% CI 24–33%). Our analysis shows that IO approvals for mRCC since 2019 have led to an immediate and large increase in IO use to approximately 80% of patients who receive systemic treatment. Patient summary: Since 2019, systemic treatments for metastatic kidney cancer have shifted from drugs targeting selected proteins to immunotherapy. Our results show trends over time for more favorable characteristics among patients receiving systemic treatment and improvements in survival.http://www.sciencedirect.com/science/article/pii/S2666168325000503Metastatic renal cancerMetastatic renal cell carcinomaImmune checkpoint inhibitorsImmunotherapyOverall survivalSurvival |
| spellingShingle | Hilin Yildirim Anke Richters Adriaan D. Bins Arnoud W. Postema Maureen J.B. Aarts Martijn G.H. van Oijen Patricia J. Zondervan Katja K.H. Aben Immunotherapy in metastatic renal cell carcinoma: Insights from a Dutch nationwide cohort European Urology Open Science Metastatic renal cancer Metastatic renal cell carcinoma Immune checkpoint inhibitors Immunotherapy Overall survival Survival |
| title | Immunotherapy in metastatic renal cell carcinoma: Insights from a Dutch nationwide cohort |
| title_full | Immunotherapy in metastatic renal cell carcinoma: Insights from a Dutch nationwide cohort |
| title_fullStr | Immunotherapy in metastatic renal cell carcinoma: Insights from a Dutch nationwide cohort |
| title_full_unstemmed | Immunotherapy in metastatic renal cell carcinoma: Insights from a Dutch nationwide cohort |
| title_short | Immunotherapy in metastatic renal cell carcinoma: Insights from a Dutch nationwide cohort |
| title_sort | immunotherapy in metastatic renal cell carcinoma insights from a dutch nationwide cohort |
| topic | Metastatic renal cancer Metastatic renal cell carcinoma Immune checkpoint inhibitors Immunotherapy Overall survival Survival |
| url | http://www.sciencedirect.com/science/article/pii/S2666168325000503 |
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