PMID- 33866526
OWN - NLM
STAT- MEDLINE
DCOM- 20210521
LR  - 20240402
IS  - 1865-8652 (Electronic)
IS  - 0741-238X (Print)
IS  - 0741-238X (Linking)
VI  - 38
IP  - 5
DP  - 2021 May
TI  - Real-World Outcomes Among US Veterans Health Administration Patients Newly 
      Diagnosed with Metastatic Renal Cell Carcinoma and Treated with First-Line 
      Monotherapy.
PG  - 2644-2661
LID - 10.1007/s12325-021-01657-2 [doi]
AB  - INTRODUCTION: Substantial unmet needs exist among patients with metastatic renal 
      cell carcinoma (mRCC). This retrospective study evaluated treatment patterns as 
      well as clinical and economic outcomes associated with first-line monotherapy 
      among patients with mRCC in the USA. METHODS: Newly diagnosed patients with mRCC 
      initiating at least one first-line therapy (1L) from 1 October 2013 to 31 March 
      2018 (index date = 1L start date) were identified from the US Veterans Health 
      Administration database. Treatment patterns, clinical outcomes (time to next 
      treatment [TNT] defined by earliest of switch to non-index therapy or 
      re-initiation of index therapy after a more than 90-day gap, time to treatment 
      discontinuation [TTD], overall survival [OS]), and costs were evaluated among 
      patients treated with tyrosine kinase inhibitors (TKI), mammalian target of 
      rapamycin inhibitors (mTOR), immune checkpoint inhibitors (ICI), and other 
      monotherapies. Standard descriptive statistics were presented. The Kaplan-Meier 
      method was used to evaluate clinical outcomes. RESULTS: Of 759 patients (median 
      age 68.0 years), 85.0%, 8.0%, 4.3%, and 2.6% were treated with TKI, mTOR, ICI, or 
      other therapy in 1L, respectively. Advancement rates (to second-line [2L] 
      therapy) ranged from 10.0 (ICI) to 45.1 per 100 person years (TKI). The 12-month 
      OS rates ranged from 47.4% (TKI) to 67.7% (mTOR). The median TNT ranged from 3.8 
      (mTOR) to 9.6 months (ICI), and median TTD ranged from 2.3 (mTOR) to 4.7 months 
      (TKI). Total all-cause mean costs per patient per month ranged from $12,466 
      (mTOR) to $19,812 (ICI). CONCLUSION: These results indicate high unmet medical 
      needs among patients with mRCC treated with 1L monotherapies. Novel combination 
      therapies (e.g., ICI + ICI, ICI + TKI) may improve front-line outcomes for 
      patients with poor prognoses.
FAU - Bhanegaonkar, Abhijeet
AU  - Bhanegaonkar A
AD  - EMD Serono Inc., Rockland, MA, USA; an affiliate of Merck KGaA, Darmstadt, 
      Germany. abhijeet.bhanegaonkar@emdserono.com.
FAU - Pandya, Shivani
AU  - Pandya S
AD  - STATinMED Research, Plano, TX, USA.
FAU - Zheng, Ying
AU  - Zheng Y
AD  - EMD Serono Inc., Rockland, MA, USA; an affiliate of Merck KGaA, Darmstadt, 
      Germany.
FAU - Kim, Ruth
AU  - Kim R
AD  - Pfizer, Inc., New York, NY, USA.
FAU - Krulewicz, Stan
AU  - Krulewicz S
AD  - Pfizer, Inc., Collegeville, PA, USA.
FAU - Kasturi, Vijay
AU  - Kasturi V
AD  - EMD Serono Inc., Rockland, MA, USA; an affiliate of Merck KGaA, Darmstadt, 
      Germany.
FAU - Phatak, Hemant
AU  - Phatak H
AD  - EMD Serono Inc., Rockland, MA, USA; an affiliate of Merck KGaA, Darmstadt, 
      Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210417
PL  - United States
TA  - Adv Ther
JT  - Advances in therapy
JID - 8611864
RN  - 0 (Protein Kinase Inhibitors)
MH  - Aged
MH  - *Carcinoma, Renal Cell/drug therapy
MH  - Humans
MH  - *Kidney Neoplasms/drug therapy
MH  - Protein Kinase Inhibitors
MH  - Retrospective Studies
MH  - Veterans Health
PMC - PMC8107174
OTO - NOTNLM
OT  - Health care resource utilization
OT  - Health economics and outcomes research
OT  - Immune checkpoint inhibitors
OT  - Metastatic renal cell carcinoma
OT  - Nephrology
OT  - Oncology
OT  - Tyrosine kinase inhibitors
EDAT- 2021/04/19 06:00
MHDA- 2021/05/22 06:00
PMCR- 2021/04/17
CRDT- 2021/04/18 21:03
PHST- 2020/10/29 00:00 [received]
PHST- 2021/02/04 00:00 [accepted]
PHST- 2021/04/19 06:00 [pubmed]
PHST- 2021/05/22 06:00 [medline]
PHST- 2021/04/18 21:03 [entrez]
PHST- 2021/04/17 00:00 [pmc-release]
AID - 10.1007/s12325-021-01657-2 [pii]
AID - 1657 [pii]
AID - 10.1007/s12325-021-01657-2 [doi]
PST - ppublish
SO  - Adv Ther. 2021 May;38(5):2644-2661. doi: 10.1007/s12325-021-01657-2. Epub 2021 
      Apr 17.