Racial Disparities in Survival Among Patients With Advanced Renal Cell Carcinoma in the Targeted Therapy Era

BACKGROUND: Historically, African American (AA) patients with renal cell carcinoma (RCC) have had inferior; survival compared with Caucasian;patients. Recent studies staggest that the survival disparity between races may be worsening since the advent of targeted therapies for RCC. In this study, survival rates among AA and Caucasian patients with advanced RCC are examined aver time to determine whether a disparity in survival persists in the targeted therapy era. METHODS: The authors identified patients with stage IV RCC in the National Cancer Data Base and compared survival between AA and Caucasian patients during the periods before (1998-2004) and after (2006-2011) the advent of targeted therapy. RESULTS: In total, 48,846 patients were identified, and 10% were AA. Three-year survival among both AA and Caucasian patients improved between the 2 periods (P <.01 for both), with no interamtion observed between race and improved survival over time (P =.15). The adjusted hazard ratio (MR) for death among AAs compared with Caucasians was 113 (95% confidence interval, 1.08-119) in the post-targeted therapy ere, which was unchanged from the jaretargeted therapy era (adjusted MR, 1.10; 95% confidence interval, 1.04-1.15). The adjusted HR was similar when the analysis was restricted to those who received systemic therapy. CONCLUSIONS: Both AA and Caucasian patients with advanced RCC have had a. significant improvement in survival since the advent of targeted therapy. However; AA patients maintain a survival disadvantage compared with Caucasians independent of treatment received, potentially related to unmeasured comorbiclities, disease burden, or tumor biology. (C) 2016 American Cancer Society.