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Attend this session at the
2019 ASCO Annual Meeting!


Session: Genitourinary (Nonprostate) Cancer

Type: Poster Session

Time: Monday June 3, 1:15 PM to 4:15 PM

Location: Hall A


Session: Genitourinary (Nonprostate) Cancer

Type: Poster Discussion Session

Time: Monday June 3, 4:30 PM to 6:00 PM

Location: Hall D2

Active surveillance in metastatic renal cell carcinoma (mRCC): Results from the Canadian Kidney Cancer information system (CKCis).

Sub-category:
Kidney Cancer

Category:
Genitourinary (Nonprostate) Cancer

Meeting:
2019 ASCO Annual Meeting

Abstract No:
4516

Poster Board Number:
Poster Discussion Session (Board #342)

Citation:
J Clin Oncol 37, 2019 (suppl; abstr 4516)

Author(s): Igal Kushnir, Naveen S. Basappa, Sunita Ghosh, Aly-Khan A. Lalani, Denis Soulieres, Georg A. Bjarnason, Lori Wood, David Dawe, Christian K. Kollmannsberger, Daniel Yick Chin Heng, Anil Kapoor, Aaron Richard Hansen, Frederic Pouliot, M. Neil Reaume; Ottawa Hospital Cancer Centre, Ottawa, ON, Canada; Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada; Cross Cancer Institute/University of Alberta, Edmonton, AB, Canada; Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada; Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada; Dalhousie University, Halifax, NS, Canada; CancerCare Manitoba, University of Manitoba, Winnipeg, MB, Canada; BC Cancer–Vancouver Cancer Centre, Vancouver, BC, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; McMaster Institute of Urology, St Joseph's Healthcare, Hamilton, ON, Canada; Princess Margaret Cancer Centre, Toronto, ON, Canada; Dept. of Surgery, Urology Division, Laval University, Quebec, QC, Canada; The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada

Abstract Disclosures

Abstract:

Background: Active surveillance (AS) is a commonly used strategy in patients (pts) with low tumor burden or slow growing disease. However, few studies have assessed AS for mRCC compared to immediate treatment. We aimed to assess the outcomes and safety of AS in comparison to immediate systemic treatment for mRCC pts. Methods: Using CKCis, mRCC pts diagnosed between January 1, 2011 and December 31, 2016 were identified. AS strategy was defined as: (1) start of systemic therapy ≥6 months after diagnosis of mRCC; or (2) never receiving systemic therapy for mRCC with an overall survival (OS) ≥1 yr (OS ≥ 1 yr a surrogate to exclude pts not started on treatment due to poor prognosis). Pts starting systemic treatment < 6 months after diagnosis of mRCC were defined as receiving immediate systemic treatment. OS and time until 1st line treatment failure (TTF) between the two cohorts were compared. Results: A total of 863 pts met criteria for AS (cohort A). Of these, 370 started treatment ≥ 6 months after their initial diagnosis (cohort A1) and 493 never received systemic treatment and were alive for ≥1 year (cohort A2). 848 pts received immediate systemic treatment (cohort B). Median age for pts in cohort A and B was 65.1 (19.0-91.5) vs. 62.2 yrs (23.1-87.1) (p < 0.0001). Sex distribution was not statistically different. Pts in cohort A had fewer sites of metastatic disease vs. cohort B ( < 0.0001) and 23% of pts in cohort A had metastasectomy vs. 5% in cohort B (P = < 0.0001). Five-year OS probability was significantly greater for cohort A than for cohort B (70.2% vs. 32.1%; P < 0.0001). After adjusting for IMDC risk criteria and age, both OS (HR 0.46, 0.38-0.56, P < 0.0001) and TTF (HR 0.79, 0.69-0.92, P = 0.0021) were greater in cohort A1 vs. B. For cohort A1 the median time on AS was 14.2 m (range 6 – 71). Conclusions: Based on the largest analysis of AS in mRCC to date, our data suggest that a subset of pts may be safely observed without immediate initiation of systemic therapy. Prospective validation is required in the contemporary immunotherapy era.

 
Other Abstracts in this Sub-Category:

 

1. Pembrolizumab (pembro) plus axitinib (axi) versus sunitinib as first-line therapy for metastatic renal cell carcinoma (mRCC): Outcomes in the combined IMDC intermediate/poor risk and sarcomatoid subgroups of the phase 3 KEYNOTE-426 study.

Meeting: 2019 ASCO Annual Meeting Abstract No: 4500 First Author: Brian I. Rini
Category: Genitourinary (Nonprostate) Cancer - Kidney Cancer

 

2. A pilot randomized study evaluating nivolumab (nivo) or nivo + bevacizumab (bev) or nivo + ipilimumab (ipi) in patients with metastatic renal cell carcinoma (MRCC) eligible for cytoreductive nephrectomy, metastasectomy or post-treatment biopsy (Bx).

Meeting: 2019 ASCO Annual Meeting Abstract No: 4501 First Author: Jianjun Gao
Category: Genitourinary (Nonprostate) Cancer - Kidney Cancer

 

3. Randomized, double-blind phase III study of pazopanib versus placebo in patients with metastatic renal cell carcinoma who have no evidence of disease following metastasectomy: A trial of the ECOG-ACRIN cancer research group (E2810).

Meeting: 2019 ASCO Annual Meeting Abstract No: 4502 First Author: Leonard Joseph Appleman
Category: Genitourinary (Nonprostate) Cancer - Kidney Cancer

 

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