A Prospective Multicenter Evaluation of Initial Treatment Choice in Metastatic Renal Cell Carcinoma Prior to the Immunotherapy Era: The MaRCC Registry Experience.
A Prospective Multicenter Evaluation of Initial Treatment Choice in Metastatic Renal Cell Carcinoma Prior to the Immunotherapy Era: The MaRCC Registry Experience.
复制标题
DOI：
10.1016/j.clgc.2021.07.002
复制
发表时间：
2022-02
影响因子：
3.2
通讯作者：
中科院分区：
文献类型：
--
作者：
转移性肾细胞癌登记处提供了转移性肾细胞癌 (mRCC) 患者真实治疗模式和结果的前瞻性数据。本研究共纳入 376 名既往未接受全身治疗的 mRCC 患者。本报告描述了最初的现实世界治疗模式。医生对疗效的重视超过了生活质量和毒性，这表明需要更多的数据和教育。转移性肾细胞癌 (MaRCC) 登记处提供有关转移性肾细胞癌 (mRCC) 患者的真实治疗模式和结果的前瞻性数据。在学术和社区中心招募了既往未接受全身治疗的转移性肾细胞癌患者。研究数据收集于 2019 年 3 月结束。结果包括总生存期 (OS)。对治疗医生的一项调查评估了开始和停止治疗的原因。总体而言，376 名 mRCC 患者开始了一线治疗； 171 人 (45.5%) 接受帕唑帕尼治疗，75 人 (19.9%) 接受舒尼替尼治疗，74 人 (19.7%) 参加临床试验。临床试验组的中位 OS（95% 置信区间）最长（50.3 [35.8-未达到] 个月），而帕唑帕尼组为 39.0 [29.7-50.9] 个月，舒尼替尼为 26.2 [19.9-61.5] 个月。非透明细胞 RCC（21.5% 的患者）与透明细胞 RCC 相比，中位 OS 较差（18.0 个月与 47.3 个月）。治疗组之间基线特征、治疗起始剂量和相对剂量暴露的差异表明选择偏倚。调查结果显示，与治疗选择的疗效相比，不重视生活质量、毒性和患者偏好。 MaRCC 注册中心深入了解现实世界的一线治疗选择、结果以及免疫治疗时代之前关于初始治疗选择的医生理由。临床试验和非研究患者之间结果的差异反映了将试验结果转化为现实世界患者的困难，并强调了扩大临床试验资格的必要性。医生对疗效的重视超过了生活质量和毒性，这表明需要更多关于这些终点的数据和教育。
The Metastatic Renal Cell Carcinoma Registry provides prospective data on real-world treatment patterns and outcomes in patients with metastatic renal cell carcinoma (mRCC). A total of 376 patients with mRCC and no prior systemic therapy were included in this study. This report describes initial real-world treatment patterns. Physician emphasis on efficacy over quality of life and toxicity suggests more data and education are needed. The Metastatic Renal Cell Carcinoma (MaRCC) Registry provides prospective data on real-world treatment patterns and outcomes in patients with metastatic renal cell carcinoma (mRCC). Patients with mRCC and no prior systemic therapy were enrolled at academic and community sites. End of study data collection was in March 2019. Outcomes included overall survival (OS). A survey of treating physicians assessed reasons for treatment initiations and discontinuations. Overall, 376 patients with mRCC initiated first-line therapy; 171 (45.5%) received pazopanib, 75 (19.9%) sunitinib, and 74 (19.7%) participated in a clinical trial. Median (95% confidence interval) OS was longest in the clinical trial group (50.3 [35.8-not reached] months) versus pazopanib (39.0 [29.7-50.9] months) and sunitinib 26.2 [19.9-61.5] months). Non-clear cell RCC (21.5% of patients) was associated with worse median OS than clear cell RCC (18.0 vs. 47.3 months). Differences in baseline characteristics, treatment starting dose, and relative dose exposure among treatment groups suggest selection bias. Survey results revealed a de-emphasis on quality of life, toxicity, and patient preference compared with efficacy in treatment selection. The MaRCC Registry gives insights into real-world first-line treatment selection, outcomes, and physician rationale regarding initial treatment selection prior to the immunotherapy era. Differences in outcomes between clinical trial and off-study patients reflect the difficulty in translating trial results to real-world patients, and emphasize the need to broaden clinical trial eligibility. Physician emphasis on efficacy over quality of life and toxicity suggests more data and education are needed regarding these endpoints.
登录
查看更多内容
影响因子：
4.4
作者：
Gonzalez, Juan Marcos;Doan, Justin;Fishman, Mayer
通讯作者：
Fishman, Mayer
影响因子：
6.2
作者：
Harrison MR;Costello BA;Bhavsar NA;Vaishampayan U;Pal SK;Zakharia Y;Jim HSL;Fishman MN;Molina AM;Kyriakopoulos CE;Tsao CK;Appleman LJ;Gartrell BA;Hussain A;Stadler WM;Agarwal N;Pachynski RK;Hutson TE;Hammers HJ;Ryan CW;Inman BA;Mardekian J;Borham A;George DJ
通讯作者：
George DJ
影响因子：
158.5
作者：
Motzer, Robert J.;Hutson, Thomas E.;Choueiri, Toni K.
通讯作者：
Choueiri, Toni K.
影响因子：
3.3
作者：
Hutson, Thomas E.;Jiao, Xiaolong;MacLean, Elizabeth A.
通讯作者：
MacLean, Elizabeth A.
影响因子：
158.5
作者：
Motzer, Robert;Alekseev, Boris;Choueiri, Toni K.
通讯作者：
Choueiri, Toni K.