Tracy L Rose1,2, Allison M Deal3, Bhavani Krishnan2, Matthew E Nielsen2,4, Angela B Smith2,4, William Y Kim1,2, Matthew I Milowsky5,6. 1. Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina. 2. University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina. 3. Biostatistics and Clinical Data Management Core, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina. 4. Urologic Oncology Program, Department of Urology, University of North Carolina, Chapel Hill, North Carolina. 5. Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina. matt_milowsky@med.unc.edu. 6. University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina. matt_milowsky@med.unc.edu.
Abstract
BACKGROUND: Historically, African American (AA) patients with renal cell carcinoma (RCC) have had inferior survival compared with Caucasian patients. Recent studies suggest that the survival disparity between races may be worsening since the advent of targeted therapies for RCC. In this study, survival rates among AA and Caucasian patients with advanced RCC are examined over time to determine whether a disparity in survival persists in the targeted therapy era. METHODS: The authors identified patients with stage IV RCC in the National Cancer Data Base and compared survival between AA and Caucasian patients during the periods before (1998-2004) and after (2006-2011) the advent of targeted therapy. RESULTS: In total, 48,846 patients were identified, and 10% were AA. Three-year survival among both AA and Caucasian patients improved between the 2 periods (P < .01 for both), with no interaction observed between race and improved survival over time (P = .15). The adjusted hazard ratio (HR) for death among AAs compared with Caucasians was 1.13 (95% confidence interval, 1.08-1.19) in the post-targeted therapy era, which was unchanged from the pretargeted therapy era (adjusted HR, 1.10; 95% confidence interval, 1.04-1.15). The adjusted HR was similar when the analysis was restricted to those who received systemic therapy. CONCLUSIONS: Both AA and Caucasian patients with advanced RCC have had a significant improvement in survival since the advent of targeted therapy. However, AA patients maintain a survival disadvantage compared with Caucasians independent of treatment received, potentially related to unmeasured comorbidities, disease burden, or tumor biology. Cancer 2016;122:2988-2995.
BACKGROUND: Historically, African American (AA) patients with renal cell carcinoma (RCC) have had inferior survival compared with Caucasian patients. Recent studies suggest that the survival disparity between races may be worsening since the advent of targeted therapies for RCC. In this study, survival rates among AA and Caucasian patients with advanced RCC are examined over time to determine whether a disparity in survival persists in the targeted therapy era. METHODS: The authors identified patients with stage IV RCC in the National Cancer Data Base and compared survival between AA and Caucasian patients during the periods before (1998-2004) and after (2006-2011) the advent of targeted therapy. RESULTS: In total, 48,846 patients were identified, and 10% were AA. Three-year survival among both AA and Caucasian patients improved between the 2 periods (P < .01 for both), with no interaction observed between race and improved survival over time (P = .15). The adjusted hazard ratio (HR) for death among AAs compared with Caucasians was 1.13 (95% confidence interval, 1.08-1.19) in the post-targeted therapy era, which was unchanged from the pretargeted therapy era (adjusted HR, 1.10; 95% confidence interval, 1.04-1.15). The adjusted HR was similar when the analysis was restricted to those who received systemic therapy. CONCLUSIONS: Both AA and Caucasian patients with advanced RCC have had a significant improvement in survival since the advent of targeted therapy. However, AA patients maintain a survival disadvantage compared with Caucasians independent of treatment received, potentially related to unmeasured comorbidities, disease burden, or tumor biology. Cancer 2016;122:2988-2995.
Authors: Bradley C Leibovich; Christine M Lohse; Paul L Crispen; Stephen A Boorjian; R Houston Thompson; Michael L Blute; John C Cheville Journal: J Urol Date: 2010-02-19 Impact factor: 7.450
Authors: Robert J Motzer; Thomas E Hutson; Piotr Tomczak; M Dror Michaelson; Ronald M Bukowski; Olivier Rixe; Stéphane Oudard; Sylvie Negrier; Cezary Szczylik; Sindy T Kim; Isan Chen; Paul W Bycott; Charles M Baum; Robert A Figlin Journal: N Engl J Med Date: 2007-01-11 Impact factor: 91.245
Authors: Liam C Macleod; Scott S Tykodi; Sarah K Holt; Jonathan L Wright; Daniel W Lin; Maria S Tretiakova; Lawrence D True; John L Gore Journal: Urology Date: 2015-07-18 Impact factor: 2.649
Authors: Gary Hudes; Michael Carducci; Piotr Tomczak; Janice Dutcher; Robert Figlin; Anil Kapoor; Elzbieta Staroslawska; Jeffrey Sosman; David McDermott; István Bodrogi; Zoran Kovacevic; Vladimir Lesovoy; Ingo G H Schmidt-Wolf; Olga Barbarash; Erhan Gokmen; Timothy O'Toole; Stephanie Lustgarten; Laurence Moore; Robert J Motzer Journal: N Engl J Med Date: 2007-05-31 Impact factor: 91.245
Authors: Giuseppe Rosiello; Carlotta Palumbo; Sophie Knipper; Angela Pecoraro; Stefano Luzzago; Pierre-Antoine St-Hilaire; Zhe Tian; Umberto Capitanio; Francesco Montorsi; Shahrokh F Shariat; Fred Saad; Alberto Briganti; Pierre I Karakiewicz Journal: World J Urol Date: 2020-04-06 Impact factor: 4.226
Authors: Lauren L Palazzo; Deirdre F Sheehan; Angela C Tramontano; Chung Yin Kong Journal: Cancer Epidemiol Biomarkers Prev Date: 2019-02-20 Impact factor: 4.254
Authors: Gabriele Sorce; Benedikt Hoeh; Lukas Hohenhorst; Andrea Panunzio; Stefano Tappero; Nancy Nimer; Zhe Tian; Alessandro Larcher; Umberto Capitanio; Derya Tilki; Carlo Terrone; Felix K H Chun; Alessandro Antonelli; Fred Saad; Shahrokh F Shariat; Francesco Montorsi; Alberto Briganti; Pierre I Karakiewicz Journal: World J Urol Date: 2022-10-12 Impact factor: 3.661
Authors: Lisa P Spees; Michaela A Dinan; Bradford E Jackson; Christopher D Baggett; Lauren E Wilson; Melissa A Greiner; Deborah R Kaye; Tian Zhang; Daniel J George; Charles D Scales; Jessica E Pritchard; Michael Leapman; Cary P Gross; Stephanie B Wheeler Journal: Clin Genitourin Cancer Date: 2022-04-25 Impact factor: 3.121
Authors: Deborah R Kaye; Lauren E Wilson; Melissa A Greiner; Lisa P Spees; Jessica E Pritchard; Tian Zhang; Craig E Pollack; Daniel George; Charles D Scales; Chris D Baggett; Cary P Gross; Michael S Leapman; Stephanie B Wheeler; Michaela A Dinan Journal: J Geriatr Oncol Date: 2022-02-04 Impact factor: 3.929
Authors: David J Paulucci; John P Sfakianos; Anders J Skanderup; Kathleen Kan; Che-Kai Tsao; Matthew D Galsky; A Ari Hakimi; Ketan K Badani Journal: Oncotarget Date: 2017-01-17