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We retrospectively analyzed real-world data from the ARON-1 project for patients with papillary renal cell carcinoma who received first-line immune-based combinations or tyrosine kinase inhibitors. Immune-based combinations were associated with better 1-yr and 2-yr overall survival rates, better median progression-free survival, and a better objective response rate. Immune-based combinations are the preferable option for first-line treatment in this setting.

Obesity has been associated with improved response to immunotherapy in cancer patients. We investigated the role of body mass index (BMI) in patients from the ARON-1 study (NCT05287464) treated by dual immuno-oncology agents (IO+IO) or a combination of immuno-oncology drug and a tyrosine kinase inhibitors (TKI) as first-line therapy for metastatic renal cell carcinoma (mRCC).

•Immune-based combinations are the standard systemic treatment for mRCC.•IMDC prognostic risk score is a prognostic tool developed and validated in the systemic targeted therapy era.•SII is associated with survival in several solid neoplasm.•This international multicenter study showed that SII could be a feasible prognostic tool to be used in daily practice.

Renal cancer is one of the most frequent genitourinary tumors. Treatment is currently based on immunotherapy combinations or immunotherapy with tyrosine kinase inhibitors (TKIs), but there are no comparisons in this regard with solid data. The real-life data presented reveal better data in overall (OS) and progression-free (PFS) survival in the intermediate prognosis population with immune-oncology (IO)-TKI versus IO-IO combination. No differences in OS and PFS were found between the two combinations in poor-prognosis patients.

Aims and background Clinical practice shows significant differences in treatment outcomes and toxicity of sunitinib across patients. This retrospective study assessed early predictive markers for progression-free survival (PFS) in patients with metastatic clear cell renal cell carcinoma (RCC) treated with sunitinib in the first-line setting.Methods We evaluated 28 patients with stage IV clear cell RCC (with good or intermediate MSKCC risk prognosis) treated at the Department of Oncology, University Hospital, Cracow between 2008 and 2013. Data included demographic profiles, adverse events during first cycle of therapy, treatment delays, and treatment outcomes. Sunitinib was administered on a standard schedule (50 mg/day, 4 weeks on, 2 weeks off). PFS values were estimated with the Kaplan-Meier method and compared using the log-rank test; we identified independent PFS predictors using multiple Cox regression models.Results PFS was significantly longer in patients who experienced at least 1 adverse event after the first cycle of sunitinib (median 17.6 months vs. 5.6; p = 0.006). Hypertension and hand-foot syndrome were significantly correlated with longer PFS (29.3 vs. 6.0 months; p = 0.002, and not reached vs. 9.8 months; p = 0.002, respectively). We observed a similar (though not significant) tendency for neutropenia (17.5 vs. 8.4 months; p = 0.055). In multiple Cox regression, hypertension was the only individual independent predictor of PFS, but the co-occurrence of any 2 or 3 sunitinib-induced adverse events also predicted longer survival.Conclusions Although small, our study suggests that hypertension and hand-foot syndrome predict longer PFS in patients with clear cell RCC treated with sunitinib. The co-occurrence of 2 or more side effects seems also a significant predictor of longer survival. Larger studies are warranted to confirm the correlation between co-occurring side effects and PFS.