ICI Therapy Offers Effectiveness for Black vs White Patients With RCC

3D rendering of human kidney on science background: © Rasi - stock.adobe.com

According to a real-world study performed by researchers at Fox Chase Cancer Center, treatment recommendations for Black and White patients with metastatic renal cell carcinoma (RCC) should be the same, with immune checkpoint inhibitor-based treatment (ICI) offered to both.¹

ICI was shown to be equally effective as a frontline treatment for both Black and White patients with metastatic RCC as in separate analyses, Black and White patients receiving ICI-based therapy had better real-world progression-free survival (PFS) compared with patients treated with sunitinib (Sutent).²

The median real-world PFS was 9.3 months for White patients who received an ICI plus a tyrosine kinase inhibitor (TKI) vs 7.0 months for those who received sunitinib ( P <.001). Among patients who were Black, the real-world median PFS was 7.8 months when treated with ICI plus a TKI vs 5.4 months for those given sunitinib (P = .6).¹

Additionally, the median PFS in patients who were White was 5.7 months for those who received an ICI plus an ICI (P = .1) vs 7.0 months for those receiving sunitinib (P = .1) and 7.2 months vs 7.0 months for those who were treated with an ICI in combination with another ICI or a TKI vs sunitinib (P = .002). For patients who were Black, the median PFS was 4.7 months among those given an ICI combination compared with 5.4 months for sunitinib (P = .5) and 5.6 months for those given an ICI plus another ICI or a TKI vs 5.4 months for sunitinib (P = .4).

“There is a potential benefit of ICI in both Black and White populations, so we should not differentiate the treatment options based on race,” said Jasmeet Kaur, MD, the lead author on the study and a second-year fellow in the Department of Hematology/Oncology at Fox Chase, in a press release.²

Studies exploring immune gene signatures for predicting response to ICI in RCC have shown variations between Black and White patients. To investigate if these genetic differences translate to real-world outcomes, researchers, including Kaur, conducted a study comparing PFS after treatment.

Researchers at Fox Chase Cancer Center reviewed anonymized medical records of 2592 patients with RCC who were treated with either ICI therapy or sunitinib since 2011. In the retrospective cohort study, data were gathered on the available races of patients with metastatic RCC who were treated in the frontline with an ICI plus another ICI, an ICI plus a TKI, or sunitinib. The majority of patients (nearly 92%) were White, and 56% of patients received ICI treatment.

The primary end point of the study was to compare real-world PFS among patients who were Black and White, which was calculated for each patient group through the use of Kaplan-Meier curves, log-rank tests, and Cox proportional models.

An additional finding from the trial showed that there were no significant differences in outcomes between Black and White patients when adjusting the analyses to compare treatment outcomes. This study shows comparable findings between Black and White patients with RCC when receiving ICI therapy.

REFERENCES:

1. Kaur J, Hasler JS, Handorf EA, et al. Comparison of outcomes between patients of African and European descent with metastatic renal cell carcinoma receiving immune checkpoint inhibitors. J Clin Oncol. 2024;42(suppl 4):369. doi:10.1200/JCO.2024.42.4_suppl.369

2. New Fox Chase study finds immunotherapy effective for both black and white patients with metastatic renal cell carcinoma. News release. Fox Chase Cancer Center. January 26, 2024. Accessed April 1, 2024. https://tinyurl.com/5n7syz8y