Clinical features and outcomes in Hispanic/Latino (HL) with metastatic renal cell carcinoma (mRCC) treated with systemic therapy.

Abstract

e16525 Background: RCC has a rising worldwide incidence. Data on clinical features and outcomes in the HLs with mRCC are limited. This is a retrospective study conducted at Sylvester Comprehensive Cancer Center (SCCC), serving a large HL population, comparing clinical features and outcomes between HL and non-HL (NHL) patients (pts). Methods: Data on mRCC pts treated at SCCC between 2010 to 2022 were retrospectively reviewed. Baseline characteristics were obtained using chi-square, Fisher’s exact test and Wilcoxon rank-sum tests. Metastasis-free survival (MFS), and overall survival (OS) were obtained by Kaplan-Meier method and compared using log rank test. Results: 766 pts with mRCC including 42% HLs were initially identified. At abstract submission, complete clinical and outcomes data were available for 323 pts, including 226 (70%) with de novo mRCC. Compared to NHLs, HLs had a lower median age (in years) at presentation (57 vs 63; p = < 0.01), comprised more females (31.6 % vs 24.5%; p = 0.03), had more solitary metastases (28.9% vs 25.6%; p = 0.04). HLs had a higher prevalence of clear cell RCC (ccRCC) histology (80% vs 69.6%; p = 0.01), and a lower prevalence of papillary and chromophobe as compared to the NHLs (7.1% vs 16.7 %; p = 0.01). HLs had a higher rate of recurrence after nephrectomy (37.4% vs 23.2%; p = < 0.01) and a lower rate of metastatectomy (20.8% vs 32.9 %; p = 0.01). For 1 st line systemic therapy, no ethnic differences were found in the use of TKIs, IO-IO, or IO-TKIs. HL pts were found to have higher rates of response [complete response (CR)/partial response (PR): 47.3% vs 33.3%; p = 0.01] than non-HL pts. Even though there was no significant difference in the duration of treatments between the two groups, HLs had a lower median duration of 1 st line treatment in pts with PR (8.2 vs 15.5 months, p = 0.09). Adverse events were similar between groups. Histology (non ccRCC vs ccRCC: OR 2.63; p = < 0.01), nephrectomy (yes vs. no: OR = 0.6; p = 0.04), and treatment type (IO vs non-IO: OR 0.52; p = 0.01 and TKI vs TKI+IO: OR 3.54; p = < 0.01) were predictors of progressive disease with 1 st line therapy. In 97 pts (30%) who developed mRCC after prior nephrectomy, there was a trend to lower MFS in the HLs (13.7 months) compared to NHLs (49.4 months) [HR 1.43 (95% CI 0.94-2.16); = 0.09]. In the total 323 pts, no ethnic difference in OS from the time of starting 1 st line treatment was seen. Higher age, nonclear cell histology, de novo metastatic disease, no prior nephrectomy, no metastatectomy, and intermediate/poor IMDC risk disease were significant predictors of worse OS. Conclusions: Important differences were found between HL and NHL pts with mRCC, including age at presentation, recurrence rate, metastatic burden, and response to 1 st therapy. Factors predicting worse OS were age, histology, de novo metastatic disease, prior surgery, and IMDC risk. Studies elucidating the biological basis of these differences are warranted.