Real-World Treatment Patterns and Effectiveness of Patients With Advanced Renal Cell Carcinoma: A Nationwide Observational Study

Given the treatment landscape evolution for aRCC, real -world data are needed. All French patients newly treated for aRCC initiated in 2016 were included. In first -line, patients were mainly treated with sunitinib, and in secondline half were treated with nivolumab. The highest OS was observed for patients treated with sunitinib in firstline and for patients treated with nivolumab in second -line. Background: Treatment landscape for advanced renal cell carcinoma (aRCC) has evolved quickly and few data about the real -world treatment patterns are available. This study aimed at describing the real -world treatment patterns and effectiveness of all systemic treatments available for aRCC in first and second -line treatment. Materials and Methods: A cohort of patients initiating a first -line systemic treatment for aRCC in 2016 was extracted from the French nationwide healthcare insurance system database (SNDS). The first -line treatment initiation date constituted the index date and patients were followed until death, loss to follow-up, or December 31, 2019, whichever occurred first. aRCC was identified using hospital diagnosis, long-term disease, or renal biopsy before index date. All analyses were performed for first and second -line treatment. Overall survival (OS) and time -to -next treatment or death (TNT -D) were estimated using Kaplan -Meier approach. Results: In 2016, 1629 patients initiated a first -line treatment for aRCC. Most of them were male (75.9%) and the median age was 67 years. Most of patients (91.7%) had received a tyrosine kinase inhibitor as first -line treatment, mainly sunitinib (64.4%), and 53.5% received a second -line, among which 43.7% nivolumab. Median OS (95% confidence interval [CI]) was 20.7 (95% CI:18.2-22.4) months from first -line treatment initiation and 15.4 (13.9-17.5) months from second -line treatment initiation. Median TNT -D were respectively 9.3 (9.7-12.1) months and 6.9 (5.9-7.7) months. Conclusion: This study highlights the limited survival of aRCC patients These results provide a valuable baseline and highlight the need for innovation, such as immune checkpoint inhibitor -based combinations that have recently became first -line standard of care.