Black and White patients treated with similar first-line therapies for advanced kidney cancer experienced similar outcomes, but different response rates, according to research from Fox Chase Cancer Center presented by Daniel Geynisman, MD, at the 2022 ASCO Annual Meeting (Abstract 4548).
“This was a retrospective study looking at potential differences in treatment patterns and outcomes between Black and White patients with metastatic kidney cancer,” said Dr. Geynisman, the study author and Chief of the Division of Genitourinary Medical Oncology at Fox Chase Cancer Center.
Dr. Geynisman said Black patients are grossly underrepresented in all advanced renal cell carcinoma trials and clinical trials in oncology in general. Little is known about the impact of racial differences in the use of first-line therapies and clinical outcomes in the real-world setting, he added.
Daniel Geynisman, MD
To address this, Dr. Geynisman and colleagues conducted a multicenter study examining data on 473 patients with advanced kidney cancer with the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC), a prognostic model to predict survival of patients with intermediate- or poor-risk disease.
The use of first-line therapy, treatment discontinuation, and clinical outcomes—including disease response, landmark progression-free survival, landmark overall survival, and treatment-related adverse event rates—were assessed descriptively by race. The likelihood of receiving first-line therapies was based on factors like performance status.
Ninety-five of the study patients were Black, and 378 were White. More Black patients presented with potentially more aggressive disease (poor-risk by IMDC criteria) and worse performance status than White patients, Dr. Geynisman said.
“The key efficacy findings are that first, Black and White patients are often treated in similar fashions. There were no significant differences in the use of immune-based combination therapies between these groups,” said Sr. Geynisman.
“The second finding is that long-term outcomes seem generally similar between the two groups. The response rates, however, were higher in White Americans than Black Americans, which is something that needs to be explored further and may have been a spurious finding due to the sample size or the retrospective conduct of the analysis,” he added.
“The next steps for this study would be to extend follow-up and to investigate why the response rates are different. We would need a larger sample size and ideally a prospective registry to really answer those questions, as well as novel genomic biomarkers to help understand any potential differences between Black and White patients with advanced kidney cancer.”
Disclosure: For full disclosures of the study authors, visit coi.asco.org.
