Trends in Metastatic Kidney Cancer Survival From the Cytokine to the Targeted Therapy Era

• Published in: Urology (Ridgewood, N.J.) N.J.), 2015-08, Vol.86 (2), p.262-268
• Main Authors: Macleod, Liam C, Tykodi, Scott S, Holt, Sarah K, Wright, Jonathan L, Lin, Daniel W, Tretiakova, Maria S, True, Lawrence D, Gore, John L
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Carcinoma, Renal Cell - drug therapy; Carcinoma, Renal Cell - mortality; Carcinoma, Renal Cell - secondary; Clinical Trials as Topic; Cytokines - therapeutic use; Female; Humans; Kidney Neoplasms - drug therapy; Kidney Neoplasms - mortality; Kidney Neoplasms - pathology; Male; Middle Aged; Molecular Targeted Therapy; Survival Rate - trends; Time Factors; Urology; Young Adult
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2015.05.008

Objective To evaluate population-based survival trends, compared to optimistic trial benchmarks, in metastatic renal cell carcinoma (mRCC). Advances in medical therapy for mRCC may be associated with survival improvements. Yet, targeted therapy trial results focus on patients with favorable-risk mRCC and may not be well disseminated at the population level. Methods Surveillance, Epidemiology, and End Results identified adult mRCC patients diagnosed between 1990 and 2009. Survival was analyzed by treatment era (cytokine, 1990-2005; targeted therapy, 2006-2009) and stratified by histology. Multivariate Cox regression identified factors independently associated with overall survival. Results We identified 14,521 eligible patients. For clear cell mRCC (N = 4149), median survival improved from 11 to 14 months before and after targeted therapy ( P