Marcus Derigs*, Günter Niegisch, Tobias R. Richter, Benedikt Mönig, Rene Mager, Axel Hegele, Thomas Steiner, Viktor Grünwald and Philipp Ivanyi
In November 2018 the European Medicines Agency approved Nivolumab plus Ipilimumab as first-line therapy in intermediate- or poor-risk Advanced Renal Cell Carcinoma (aRCC) patients. This made it mandatory to stratify patients according to their risk group before starting a therapy. Concomitantly, facility case volume was suggested to influence the quality of aRCC treatment. To this end, we retrospectively analyzed aRCC patient data for those who received first-line therapy in low- or high-volume centres in 2016 vs. 2019. Data from 5 urological and 6 oncological clinics from 95 patients showed that stratification according to the IMDC score was more frequent in high- as compared to low-volume centres in Germany in 2021 (46 vs. 13%, p =0.022). Nevertheless, Nivolumab plus Ipilimumab was used similarly in low- and high-volume centres (31 vs. 29%). However, high-volume centers had a higher clinical benefit rate of first-line therapy compared to low-volume centers (82 vs. 50%, respectively, p =0.025). Moreover, more patients were still on first-line therapy from 2019 in high-volume centers (31 vs. 9%, p =0.033). These findings suggest that case volume and patient stratification according to the IMDC risk score positively affect treatment outcomes in aRCC.
