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Published in:
Open Access 01-08-2024 | Kidney Cancer | Research
Sex and survival outcomes in patients with renal cell carcinoma receiving first-line immune-based combinations
Authors: Lorena Incorvaia, Fernando Sabino Marques Monteiro, Francesco Massari, Se Hoon Park, Giandomenico Roviello, Ondřej Fiala, Zin W. Myint, Jakub Kucharz, Javier Molina-Cerrillo, Daniele Santini, Thomas Buttner, Alexandr Poprach, Jindrich Kopecky, Annalisa Zeppellini, Martin Pichler, Tomas Buchler, Renate Pichler, Gaetano Facchini, Andre Poisl Fay, Andrey Soares, Ray Manneh, Laura Iezzi, Zsofia Kuronya, Antonio Russo, Maria T. Bourlon, Dipen Bhuva, Jawaher Ansari, Ravindran Kanesvaran, Enrique Grande, Sebastiano Buti, Matteo Santoni
Published in: Cancer Immunology, Immunotherapy | Issue 8/2024
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Background
There is an ongoing debate as to whether sex could be associated with immune checkpoint inhibitor (ICI) benefit. Existing literature data reveal contradictory results, and data on first-line immune combinations are lacking.
Method
This was a real-world, multicenter, international, observational study to determine the sex effects on the clinical outcomes in metastatic renal cell carcinoma (mRCC) patients treated with immuno-oncology combinations as first-line therapy.
Results
A total of 1827 mRCC patients from 71 cancer centers in 21 countries were included. The median OS was 38.7 months (95% CI 32.7–44.2) in the overall study population: 40.0 months (95% CI 32.7–51.6) in males and 38.7 months (95% CI 26.4–41.0) in females (p = 0.202). The median OS was higher in males vs. females in patients aged 18-49y (36.9 months, 95% CI 29.0–51.6, vs. 24.8 months, 95% CI 16.8–40.4, p = 0.426, with + 19% of 2y-OS rate, 72% vs. 53%, p = 0.006), in the clear cell histology subgroup (44.2 months, 95% CI 35.8–55.7, vs. 38.7 months, 95% CI 26.0–41.0, p = 0.047), and in patients with sarcomatoid differentiation (34.4 months, 95% CI 26.4–59.0, vs. 15.3 months, 95% CI 8.9–41.0, p < 0.001). Sex female was an independent negative prognostic factor in the sarcomatoid population (HR 1.72, 95% CI 1.15 − 2.57, p = 0.008).
Conclusions
Although the female’s innate and adaptive immunity has been observed to be more active than the male’s, women in the subgroup of clear cell histology, sarcomatoid differentiation, and those under 50 years of age showed shorter OS than males.
