Smoking Has No Effect on OS After IO-Based mRCC Therapy

SMOKING STATUS at diagnosis does not affect overall survival (OS) or time to treatment failure in patients with metastatic renal cell carcinoma (mRCC) receiving first-line, standard of care immune-oncology (IO) combination regimens, investigators reported at the American Society of Clinical Oncology’s 2023 Annual Meeting in Chicago.

“As opposed to other cancer types (i.e., NSCLC), current or past smoking history did not appear to be predictive of benefit from IO-based therapy,” Georges Gebrael, MD, of Huntsman Cancer Institute, University of Utah in Salt Lake City, Utah, and colleagues concluded in a poster presentation.

Using the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC), the researchers identified 989 patients with mRCC treated with dual immunotherapy or immunotherapy plus a VEGF-targeted therapy in the first-line setting. Of these, 438 (44.3%), 415 (42%), and 136 (13.7%) patients were never, former, and current smokers, respectively. The groups were similar in age, IMDC risk categories, body mass index, and sarcomatoid features.

On multivariable analysis, there were no significant differences in OS or time to treatment failure between the smoking status groups, Dr Gebrael reported on behalf of his team. At a median follow-up of 21.2 months, the OS rates at 2 years were 70.8%, 73.1%, and 62.8% for never, former, and current smokers, respectively. Median overall survival was 48.2 months, not reached, and 37.4 months, respectively. The time to treatment failure was 7.8, 7.3, and 6.4 months, respectively. The objective response rates were 40.9%, 48.5%, and 41.7%, respectively.

Former smokers had significant 1.5-fold increased odds of objective response to treatment compared with never smokers. The investigators observed no significant effect on objective response among current smokers. ■