Comparison of outcomes for Hispanic and non-Hispanic patients with advanced renal cell carcinoma in the International Metastatic Renal Cell Carcinoma Database
Abstract
Background
Existing data on the impact of Hispanic ethnicity on outcomes for patients with renal cell carcinoma (RCC) is mixed. The authors investigated outcomes of Hispanic and non-Hispanic White (NHW) patients with advanced RCC receiving systemic therapy at large academic cancer centers using the International Metastatic Renal Cell Carcinoma Database (IMDC).
Methods
Eligible patients included non-Black Hispanic and NHW patients with locally advanced or metastatic RCC initiating systemic therapy. Overall survival (OS) and time to first-line treatment failure (TTF) were calculated using the Kaplan–Meier method. The effect of ethnicity on OS and TTF were estimated by Cox regression hazard ratios (HRs).
Results
A total of 1563 patients (181 Hispanic and 1382 NHW) (mostly males [73.8%] with clear cell RCC [81.5%] treated with tyrosine kinase inhibitor [TKI] monotherapy [69.9%]) were included. IMDC risk groups were similar between groups. Hispanic patients were younger at initial diagnosis (median 57 vs. 59 years, p = .015) and less likely to have greater than one metastatic site (60.8% vs. 76.8%, p < .001) or bone metastases (23.8% vs. 33.4%, p = .009). Median OS and TTF was 38.0 months (95% confidence interval [CI], 28.1–59.2) versus 35.7 months (95% CI, 31.9–39.2) and 7.8 months (95% CI, 6.2–9.0) versus 7.5 months (95% CI, 6.9–8.1), respectively, in Hispanic versus NHW patients. In multivariable Cox regression analysis, no statistically significant differences were observed in OS (adjusted hazard ratio [HR], 1.07; 95% CI, 0.86–1.31, p = .56) or TTF (adjusted HR, 1.06; 95% CI, 0.89–1.26, p = .50).
Conclusions
The authors did not observe statistically significant differences in OS or TTF between Hispanic and NHW patients with advanced RCC. Receiving treatment at tertiary cancer centers may mitigate observed disparities in cancer outcomes.
CONFLICT OF INTEREST STATEMENT
Vishal Navani reports consulting fees from AstraZeneca, Sanofi, Novotech, and Oncology Education. Wanling Xie reports consulting fees from Convergent Therapeutics, Inc. Talal El Zarif received honoraria from art tempi. Neeraj Agarwal reports consulting fees from Astellas, Astra Zeneca, Aveo, Bayer, Bristol-Myers Squibb, Calithera, Clovis, Eisai, Eli Lilly, EMD Serono, Exelixis, Foundation Medicine, Genentech, Gilead, Janssen, Merck, MEI Pharma, Nektar, Novartis, Pfizer, Pharmacyclics, and Seattle Genetics; and research funding from Arnivas, Astellas, AstraZeneca, Bavarian Nordic, Bayer, Bristol-Myers Squibb, Calithera, Celldex, Clovis, Crispr, Eisai, Eli Lilly, EMD Serono, Exelixis, Genentech, Gilead, Glaxo Smith Kline, Immunomedics, Janssen, Lava, Medivation, Merck, Nektar, Neoleukin, New Link Genetics, Novartis, Oric, Pfizer, Prometheus, Rexahn, Roche, Sanofi, Seattle Genetics, Takeda, and Tracon. Jose Manuel Ruiz Morales reports fees for travel, accommodation, and expenses from Bristol-Myers Squibb (Mexico) and Novartis; fees for speaking from Bristol-Myers Squibb (Mexico), Novartis, MSD, and Asofarma; and consulting fees from Bristol-Myers Squibb (Mexico) and IPSEN. Toni K. Choueiri reports institutional and/or personal, paid and/or unpaid support for research, advisory boards, consultancy, and/or honoraria from Alkermes, AstraZeneca, Aravive, Aveo, Bayer, Bristol Myers-Squibb, Calithera, Circle Pharma, Deciphera Pharmaceuticals, Eisai, EMD Serono, Exelixis, GlaxoSmithKline, Gilead, IQVA, Infinity, Ipsen, Jansen, Kanaph, Lilly, Merck, Nikang, Nuscan, Novartis, Oncohost, Pfizer, Roche, Sanofi/Aventis, Scholar Rock, Surface Oncology, Takeda, Tempest, Up-To-Date, and continuing medical education events (i.e., Peerview, OncLive, MJH, CCO and others); institutional patents filed on molecular alterations and immunotherapy response/toxicity and ctDNA; equity in Tempest, Pionyr, Osel, Precede Bio, CureResponse, and InnDura; committee participation with the National Comprehensive Cancer Network, GU Steering Committee, ASCO/ESMO, Alliance of Canadian Comprehensive Research Universities, and KidneyCan; and support in part by the Dana-Farber/Harvard Cancer Center Kidney SPORE (2P50CA101942-16) and Program 5P30CA006516-56, the Kohlberg Chair at Harvard Medical School and the Trust Family, Michael Brigham, Pan Mass Challenge, Hinda and Arthur Marcus Fund, and Loker Pinard Funds for Kidney Cancer Research at the Dana-Farber Cancer Institute. Rana R. McKay reports involvement with an advisory board and or consulting fees from AstraZeneca, Aveo, Bayer, Bristol-Myers Squibb, Calithera, Caris, Dendreon, Eli Lilly, Esiai, Exelixis, Janssen, Merck, Myovant, Novartis, Pfizer, Sanofi, SeaGen, Sorrento Therapeutics, Telix, and Tempus; and research support from AstraZeneca, Artera, Bayer, Bristol-Myers Squibb, Exelixis, Oncternal, and Tempus. Neeraj Agarwal reports consulting fees from Bayer, Bristol-Myers Squibb, Eisai, Eli Lilly and Company, Exelixis, Foundation Medicine, Inc, Genentech, Inc, Gilead Sciences Inc, and Merck. Aaron R. Hansen reports consulting fees from Bayer, Merck Sharp and Dohme, and Pfizer; grant and/or contract funding from Boehringer Ingelheim, Bristol-Myers Squibb, F. Hoffmann-La Roche, GlaxoSmithKline, Janssen Pharmaceuticals, Karyopharm Therapeutics Inc, Merck Sharp and Dohme, and Novartis. Daniel Yick Chin Heng reports consulting fees from Alberta Health Services, Bristol Myers Squibb, Exelixis, Ipsen Pharma SAS, Merck, Novartis, and Pfizer Canada Inc. Chris Labaki reports grant and/or contract funding from Genentech. Muhieddine Labban reports fees for professional activities from Brigham and Women's Hospital. The other authors declare no conflicts of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
