Background: The upfront treatment of metastatic renal cell carcinoma (mRCC) has been revolutionized by the introduction of immune-based combinations. The role of cytoreductive nephrectomy (CN) in these patients is still debated. The ARON-1 study (NCT05287464) was designed to globally analyze real-world data of patients with mRCC receiving first-line immuno-oncology combinations. This sub-analysis was focused on the role of upfront or delayed partial or radical CN in three geographical areas (Western Europe, Eastern Europe, America/Asia). Patients and Methods: We conducted a multicenter retrospective observational study in patients with mRCC treated with firstline immune-based combinations from 55 centers in 19 countries. From 1,152 patients in the ARON-1 dataset, we selected 651 patients with de novo mRCC; 255 patients (39%) had undergone CN, partial in 14% and radical in 86% of cases; 396 patients (61%) received first-line immunebased combinations without previous nephrectomy. The primary endpoint was overall survival (OS) while progression-free survival (PFS) and the tumor response rate were secondary endpoints. Results: Median OS from the diagnosis of de novo mRCC was 41.6 months and not reached (NR) for the CN subgroup and 24.0 months for the no CN subgroup, (p<0.001). Median OS from the start of first-line therapy was NR in patients who underwent CN and 22.4 months in the no CN subgroup (p<0.001). Median OS was longer for patients who underwent CN compared to those who did not in all three geographical areas (Western Europe: NR vs. 23.7 months, p<0.001; Eastern Europe: NR vs. 29.8 months, p=0.005; America/Asia: 57.3 months vs. 25.5 months, p<0.001, respectively). Conclusion: No significant differences in terms of patients’ outcomes seem to clearly emerge from our analysis, even though the CN rate and the choice of the type of first-line immune-based combination varied across the different Cancer Centers participating in the ARON-1 project.
Abstracts of the 33rd Annual Meeting of the Italian Society of Uro-Oncology (SIUrO) / Mollica, Veronica; Massari, Francesco; Rizzo, Mimma; Morelli, Franco; Grande, Enrique; Iacovelli, Roberto; Molina-Cerrillo, Javier; De Giorgi, Ugo; Fornarini, Giuseppe; Procopio, Giuseppe; Büchler, Tomáš; Cattrini, Carlo; Caffo, Orazio; Ortega, Cinzia; Soares, Andrey; Messina, Carlo; Monteiro, Fernando Sabino M.; Rizzo, Alessandro; Buti, Sebastiano; Porta, Camillo; Santoni 19 (on behalf of the ARON-1 Working Group), Matteo. - In: ANTICANCER RESEARCH. - ISSN 1791-7530. - 43:10(2023), pp. 34.4747-34.4778. [10.21873/anticanres.16672]
Abstracts of the 33rd Annual Meeting of the Italian Society of Uro-Oncology (SIUrO)
Sebastiano ButiInvestigation
;
2023-01-01
Abstract
Background: The upfront treatment of metastatic renal cell carcinoma (mRCC) has been revolutionized by the introduction of immune-based combinations. The role of cytoreductive nephrectomy (CN) in these patients is still debated. The ARON-1 study (NCT05287464) was designed to globally analyze real-world data of patients with mRCC receiving first-line immuno-oncology combinations. This sub-analysis was focused on the role of upfront or delayed partial or radical CN in three geographical areas (Western Europe, Eastern Europe, America/Asia). Patients and Methods: We conducted a multicenter retrospective observational study in patients with mRCC treated with firstline immune-based combinations from 55 centers in 19 countries. From 1,152 patients in the ARON-1 dataset, we selected 651 patients with de novo mRCC; 255 patients (39%) had undergone CN, partial in 14% and radical in 86% of cases; 396 patients (61%) received first-line immunebased combinations without previous nephrectomy. The primary endpoint was overall survival (OS) while progression-free survival (PFS) and the tumor response rate were secondary endpoints. Results: Median OS from the diagnosis of de novo mRCC was 41.6 months and not reached (NR) for the CN subgroup and 24.0 months for the no CN subgroup, (p<0.001). Median OS from the start of first-line therapy was NR in patients who underwent CN and 22.4 months in the no CN subgroup (p<0.001). Median OS was longer for patients who underwent CN compared to those who did not in all three geographical areas (Western Europe: NR vs. 23.7 months, p<0.001; Eastern Europe: NR vs. 29.8 months, p=0.005; America/Asia: 57.3 months vs. 25.5 months, p<0.001, respectively). Conclusion: No significant differences in terms of patients’ outcomes seem to clearly emerge from our analysis, even though the CN rate and the choice of the type of first-line immune-based combination varied across the different Cancer Centers participating in the ARON-1 project.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
