The survival outcomes of metastatic non-clear cell renal cell carcinoma in the immunotherapy era: Princess Margaret Cancer Centre (PMCC) experience.
Bibliographic record
Abstract
636 Background: Immunotherapy (IO) with or without targeted therapy (TT) is the standard treatment for patients (pts) with advanced clear cell renal cell carcinoma. The evidence to support their use in metastatic non-clear cell renal cell carcinoma (nccRCC) is based on smaller prospective trials and retrospective analyses. Here, we report the survival outcomes of pts with nccRCC treated with IO containing regimens or TT. Methods: This retrospective survival analysis was performed in metastatic nccRCC pts treated with IO and/or TT at the PMCC, Toronto between 2002 and 2021. Demographics, disease characteristics and survival outcomes were collected. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meier method (log-rank). Chi-square and fisher’s exact tests were used to evaluate response rates where appropriate. Interaction between variables was estimated using Cox proportional hazards. Results: We identified 530 metastatic RCC pts, of these 69 (13%) were nccRCC treated either with an IO containing regimen or TT. Among nccRCC pts, 42 (60.9%) had papillary subtype, 10 (14.5%) chromophobe, 14 (20.3%) unclassified, and 3 (4.3%) had an XP translocation. Median age was 54 years (range: 26-75) and 48 (69.5%) were male. Overall, as per the IMDC score, 15 (21.7%), 41 (59.5%) and 13 (18.8%) pts were categorized as good, intermediate and poor risk, respectively. Median follow-up was 116 months (95%CI: 30.8-201.1 months). Pts received sunitinib (n=41), ipilimumab plus nivolumab (n=8), sorafenib (n=5), savolitinib (n=3), pembrolizumab (n=3), pazopanib (n=2), temsirolimus (n=2), pembrolizumab plus axitinib (n=1), and other TT (n=4) in the first line treatment. Everolimus (n=13), nivolumab (n=7), sunitinib (n=7), axitinib (n=2), cabozantinib (n=2), chemotherapy (n=2), pembrolizumab plus axitinib (n=1), and other TT (n=2) were given in the second line treatment. The survival outcomes and responses are shown in the table. There was no interaction between age, gender, IMDC, RCC subtypes and survival outcomes. Conclusions: While the number of pts included in our retrospective review was small, our analysis suggested that pts with metastatic nccRCC have improved survival outcomes with IO containing regimens. Validation in a prospective dataset is required before widespread clinical utilization and many trials are currently ongoing. [Table: see text]
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".