Marchioni M, et al. - This study was implemented to assess the impact of diagnosis year, defined as contemporary (2010–2014), intermediate (2006–2009) and historical (2001–2005) on cancer-specific mortality (CSM) in patients with metastatic renal cell carcinoma (mRCC). Over study time, it was noted that CSM-free survival improved as a consequence of the introduction of new therapeutic agents, however, this impact exclusively applied to patients with clear-cell mRCC (ccmRCC), but not to those with non-ccmRCC. This finding was in agreement with established efficacy of systemic therapies for ccmRCC, but lesser efficacy of these agents for non-ccmRCC.

Methods

• Within Surveillance, Epidemiology, and End Results registry (2001–2014), researchers identified patients with mRCC.
• After accounting for other-cause mortality, cumulative incidence and competing risks regression (CRR) models assessed CSM.
• Furthermore, subgroup analyses were also carried out according to histological subtype: clear-cell mRCC (ccmRCC) versus non-ccmRCC.

Results

• A total of 15,444 patients with mRCC were identified, of those, 41.0, 28.7 and 30.3% were diagnosed, respectively, in the contemporary, intermediate and historical years.
• Data showed that out of all, 47.1, 5.3 and 47.6% were, respectively, ccmRCC, non-ccmRCC and other mRCC histological variants [sarcomatoid mRCC, cyst-associated mRCC, collecting duct carcinoma and mRCC not otherwise specified (NOS)].
• Findings also demonstrated that, overall, 24-month CSM rates were, respectively, 61.0, 63.7 and 67.3% in contemporary, intermediate and historical patients.
• In all patients, higher CSM was shown by multivariable CRR models in intermediate (HR 1.11; p < 0.001) and historical patients (HR 1.24; p < 0.001) than in contemporary patients.
• Furthermore, virtually the same results were offered by multivariable CRR models focusing on ccmRCC.
• However, researchers noted that multivariable CRR models focusing on non-ccmRCC demonstrated no CSM differences according to diagnosis year (all p ≥ 0.3).