Eichhorn Susan, Pili Roberto, Epstein Joel B, Rajesh Richa, Satheeshkumar Poolakkad S
Boston Medical Center, Boston University School of Medicine, Boston, MA, 02118, USA.
Department of Medicine, Division of Hematology and Oncology, University at Buffalo, Buffalo, NY, 14203, USA.
Support Care Cancer. 2025 Mar 15;33(4):285. doi: 10.1007/s00520-025-09353-5.
The adverse outcomes and costs of immunotherapy (IT) have yet to be fully explored. Our study aims to assess the association between the use of IT in patients with metastatic renal cell carcinoma (mRCC) and the burden of illness (BOI), including coagulopathy, arrhythmia, and disparities.
The study used US national data to investigate the association between the use of IT in the mRCC and the BOI. The BOI was measured by total charges and length of stay (LOS). Additionally, we examined coagulopathy, arrhythmia, and disparities in these outcomes. This investigation was conducted using generalized linear models (glm).
Of 28,535 patients who had mRCC, 230 had previously received IT. In the adjusted glm, after accounting for other variables, "IT" was found to be associated with higher total charges- (coeff = 7.67; 95% CI 4.86 - 12.09). There was no association with IT and LOS. Coagulopathy (aOR = 5.61; 95% CI 2.40 - 13.14) and arrhythmia (aOR = 4.34; 95% CI 2.20 - 8.55) were associated with IT treatment. Moreover, compared to males, females had a lower cardiac arrhythmia risk (aOR 0.83, 95% CI 0.72-0.98). Non-whites, compared to Whites, had a higher total charge (1.21, 95% CI 1.13-1.29), higher coagulopathies (aOR 1.25; 95% CI 1.01-1.54), but lower cardiac arrhythmia risk (aOR 0.57; 95% CI 0.47-0.69).
Although IT has become increasingly important in treating mRCC, this is the first time real-world data on the costs, negative consequences, and disparities of IT are examined. The results may have important implications for creating innovative, supportive care models for this population.
免疫疗法(IT)的不良后果和成本尚未得到充分研究。我们的研究旨在评估转移性肾细胞癌(mRCC)患者使用IT与疾病负担(BOI)之间的关联,包括凝血病、心律失常和差异。
该研究使用美国国家数据调查mRCC患者使用IT与BOI之间的关联。BOI通过总费用和住院时间(LOS)来衡量。此外,我们检查了这些结果中的凝血病、心律失常和差异。这项调查使用广义线性模型(glm)进行。
在28535例mRCC患者中,230例之前接受过IT治疗。在调整后的glm中,在考虑其他变量后,发现“IT”与更高的总费用相关(系数=7.67;95%置信区间4.86 - 12.09)。IT与LOS无关联。凝血病(调整后比值比[aOR]=5.61;95%置信区间2.40 - 13.14)和心律失常(aOR=4.34;95%置信区间2.20 - 8.55)与IT治疗相关。此外,与男性相比,女性患心律失常的风险较低(aOR 0.83,95%置信区间0.72 - 0.98)。与白人相比,非白人的总费用更高(1.21,95%置信区间1.13 - 1.29),凝血病发生率更高(aOR 1.25;95%置信区间1.01 - 1.54),但患心律失常的风险较低(aOR 0.57;95%置信区间0.47 - 0.69)。
尽管IT在治疗mRCC方面变得越来越重要,但这是首次对IT的成本、负面后果和差异进行真实世界数据研究。这些结果可能对为该人群创建创新的支持性护理模式具有重要意义。