Arranz José A, Martínez Cristina, Gallego Lucía, Heredero Ana, Rebollo Pablo, Fernández Laura, Estella Elvira, Vilanova Larena David, Palomar Virginia
Department of Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Department of Oncology, IQVIA, Madrid, Spain.
Future Oncol. 2025 Sep;21(21):2767-2774. doi: 10.1080/14796694.2025.2542030. Epub 2025 Aug 7.
Advanced renal cell carcinoma (RCC) has had limited treatment options and poor prognosis. Initially, tyrosine kinase inhibitors (TKIs) increased progression-free survival (PFS) and allowed the identification of favorable (FP), intermediate (IP) and poor prognosis (PP) subgroups. While TKIs remain an option for FP patients, combinations of immune checkpoint inhibitors (IO) plus TKI in the overall population, or IO/IO in IP/PP patients, have improved overall survival (OS), and have become the standard of care. However, their adoption in clinical practice varies across countries.
We conducted a cross-sectional observational study using Oncology Dynamics™ database to assess treatment patterns in Spain.
A total of 1,587 metastatic RCC (mRCC) patients were registered, 900 in first-line treatment for clear cell mRCC (mccRCC). In 2022, among mccRCC FP patients treated by oncologists (N = 137), 92.7% received TKIs; while IP/PP patients (N = 298), 56.7% received TKIs, 27.5% antiPD1-antiCTLA4, and 13.8% antiPD1-TKI. In 2023, mccRCC FP patients (N = 124) received 94.4% TKIs; and IP/PP patients (N = 256) received 48.4% TKIs, 38.3% antiPD1-antiCTLA4, and 12.1% antiPD1-TKI.
During this period, the uptake of IO/IO and IO/TKI in clinical practice in Spain was lower than expected according to current recommendations.
晚期肾细胞癌（RCC）的治疗选择有限且预后较差。最初，酪氨酸激酶抑制剂（TKIs）提高了无进展生存期（PFS），并使识别出有利（FP）、中等（IP）和预后不良（PP）亚组成为可能。虽然TKIs仍然是FP患者的一种选择，但在总体人群中免疫检查点抑制剂（IO）加TKI的联合治疗，或在IP/PP患者中IO/IO联合治疗，已改善了总生存期（OS），并成为标准治疗方案。然而，它们在临床实践中的应用在不同国家存在差异。
我们使用肿瘤动力学™数据库进行了一项横断面观察性研究，以评估西班牙的治疗模式。
共登记了1587例转移性RCC（mRCC）患者，其中900例为一线治疗的透明细胞mRCC（mccRCC）。2022年，在肿瘤学家治疗的mccRCC FP患者中（N = 137），92.7%接受了TKIs治疗；而IP/PP患者（N = 298）中，56.7%接受了TKIs治疗，27.5%接受了抗PD1-抗CTLA4治疗，13.8%接受了抗PD1-TKI治疗。2023年，mccRCC FP患者（N = 124）中94.4%接受了TKIs治疗；IP/PP患者（N = 256）中48.4%接受了TKIs治疗，38.3%接受了抗PD1-抗CTLA4治疗，12.1%接受了抗PD1-TKI治疗。
在此期间，西班牙临床实践中IO/IO和IO/TKI的应用低于当前推荐的预期。
