Background: Despite several first-line immuno-combinations in mRCC, there are no formal comparisons or biomarkers to guide the treatment choice. In this context, the ongoing Meet-URO 33 study will recruit pts in up to 80 Italian centers to answer many clinical unmet needs. Methods: The Meet-URO 33 study is a multicenter prospective/retrospective registry of a real-world mRCC population receiving first-line therapy from January 2021. As of April 2024, 421 pts from 25 Italian centers were included. We investigated which clinical parameters (age, ECOG PS, type/number of comorbidities, steroid use, surgery of primary tumor, histology, sarcomatoid features, type/number of metastases, IMDC and Meet- URO scores) influenced investigators’ choice. Results: Overall, 344 (81.7%) pts received an immunocombo: 160 (46.5%) Pembro + Axi (P+A), 81 (23.6%) Nivo + Ipi (N+I), 63 (18.3%) Nivo + Cabo (N+C), 40 (11.6%) Pembro + Lenva (P+L). At univariate analysis, the IMDC and Met-URO scores, histology, bone and pancreatic metastases, and metabolic comorbidities significantly associated with an immuno-combo choice. Specifically, N+I population had a higher percentage of IMDC intermediate-risk pts while P+L poor-risk pts (p=0.002). According to the Meet-URO score, the worst prognostic group (group 5) was predominantly treated with P+A and N+C (p=0.043). Metabolic comorbidities correlated with a more frequent choice of N+I and less of P+L (p=0.019). P+L option was significantly preferred in clear-cell histology, while N+C with the higher percentage of papillary histology (p=0.047). Bone metastases correlated with N+C and less with N+I and P+L (p=0.021), while pancreatic metastases were associated with P+L and less with N+I and N+C (p=0.006). Conclusions: Despite the bias linked to the different prescription indications over time, the associations observed from this real-world scenario confirmed the consideration of well-known prognostic factors in the therapeutic choice; however these findings should be also interpreted as a general reflection of the oncologists experience. Associations of clinical parameters will be assessed within a larger sample size.
Clinical parameters for first-line immuno-combinations choice in metastatic renal cell carcinoma (mRCC) patients (pts): the Meet-URO 33 study / Cavasin, N.; Bimabatti, D.; Signori, A.; Basso, U.; Fratino, L.; Bronte, E.; De Tursi, M.; Pierantoni, F.; Ortega, C.; Zago, G.; De Vivo, R.; Buffoni, M.; Bracarda, S.; Iacovelli, R.; Silvia, C.; Fantinel, E.; Rescigno, P.; Banna, G. L.; Buti, S.; Rebuzzi, S. E.. - In: TUMORI. - ISSN 0300-8916. - 110:2_suppl(2024), pp. D36.126-D36.126. [10.1177/03008916241277279]
Clinical parameters for first-line immuno-combinations choice in metastatic renal cell carcinoma (mRCC) patients (pts): the Meet-URO 33 study
Buti S.Conceptualization
;
2024-01-01
Abstract
Background: Despite several first-line immuno-combinations in mRCC, there are no formal comparisons or biomarkers to guide the treatment choice. In this context, the ongoing Meet-URO 33 study will recruit pts in up to 80 Italian centers to answer many clinical unmet needs. Methods: The Meet-URO 33 study is a multicenter prospective/retrospective registry of a real-world mRCC population receiving first-line therapy from January 2021. As of April 2024, 421 pts from 25 Italian centers were included. We investigated which clinical parameters (age, ECOG PS, type/number of comorbidities, steroid use, surgery of primary tumor, histology, sarcomatoid features, type/number of metastases, IMDC and Meet- URO scores) influenced investigators’ choice. Results: Overall, 344 (81.7%) pts received an immunocombo: 160 (46.5%) Pembro + Axi (P+A), 81 (23.6%) Nivo + Ipi (N+I), 63 (18.3%) Nivo + Cabo (N+C), 40 (11.6%) Pembro + Lenva (P+L). At univariate analysis, the IMDC and Met-URO scores, histology, bone and pancreatic metastases, and metabolic comorbidities significantly associated with an immuno-combo choice. Specifically, N+I population had a higher percentage of IMDC intermediate-risk pts while P+L poor-risk pts (p=0.002). According to the Meet-URO score, the worst prognostic group (group 5) was predominantly treated with P+A and N+C (p=0.043). Metabolic comorbidities correlated with a more frequent choice of N+I and less of P+L (p=0.019). P+L option was significantly preferred in clear-cell histology, while N+C with the higher percentage of papillary histology (p=0.047). Bone metastases correlated with N+C and less with N+I and P+L (p=0.021), while pancreatic metastases were associated with P+L and less with N+I and N+C (p=0.006). Conclusions: Despite the bias linked to the different prescription indications over time, the associations observed from this real-world scenario confirmed the consideration of well-known prognostic factors in the therapeutic choice; however these findings should be also interpreted as a general reflection of the oncologists experience. Associations of clinical parameters will be assessed within a larger sample size.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
