Real-World Outcomes in Advanced Clear Cell Renal Cell Carcinoma: A Retrospective Analysis Comparing New Zealand and Australian Cohorts.

Abstract

PURPOSE: Advances in the systemic treatment for advanced clear cell renal cell carcinoma (ccRCC) have led to improvements in survival time. Globally, access to therapies with proven benefit, such as immune checkpoint inhibitors (ICPIs) and tyrosine kinase inhibitors, varies. Our investigation assessed whether patients from New Zealand have differential outcomes compared with their Australian counterparts. METHOD(S): In this retrospective cohort study, outcomes for patients treated with systemic therapy for advanced ccRCC in New Zealand (Auckland and Waikato) and Australia (Melbourne) were compared. Overall survival (OS) was the primary outcome. Key secondary outcomes included number of lines of systemic therapy received and the proportion of patients receiving an ICPI. RESULT(S): One hundred and eighty-three, 101, and 66 patients were eligible for inclusion from Auckland, Waikato, and Australia, respectively, between 2010 and 2019. Median OS time was longer for the Australian cohort compared with the combined New Zealand cohort (56 v 17 months, hazard ratio, 0.40, P < .0001). Increased receipt of subsequent-line therapies was observed in the Australian cohort (24% v 11% received third line). A higher proportion of patients in the Australian cohort received an ICPI-containing regimen (41% v 13%). CONCLUSION(S): Clinically meaningful differences in survival time were seen for patients treated with systemic therapy for advanced ccRCC between the New Zealand and Australian cohorts. These differences were greater than anticipated, with shorter survival time for patients in New Zealand. This analysis supports efforts to improve access to systemic therapies for patients with advanced ccRCC in New Zealand.