{"doi":"10.3389/fonc.2021.701345","title":"Racial Differences in Clinical Outcomes for Metastatic Renal Cell Carcinoma Patients Treated With Immune-Checkpoint Blockade","abstract":"Background Immune-checkpoint-inhibitors (ICIs) have become the cornerstone of metastatic renal-cell-carcinoma (mRCC) therapy. However, data are limited regarding clinical outcomes by race. In this study, we compared the real-world outcomes between African American (AA) and Caucasian mRCC patients treated with ICIs. Methods We performed a retrospective study of 198 patients with mRCC who received ICI at the Emory Winship Cancer Institute from 2015-2020. Clinical outcomes were measured by overall survival (OS), progression-free survival (PFS), and overall response rate (ORR) defined as a complete or partial response maintained for at least 6 months per response evaluation criteria in solid tumors version 1.1. Univariate and multivariable analyses were carried out for OS and PFS by Cox proportional-hazard model and ORR by logistical-regression model. Descriptive statistics compared rates of immune-related adverse events (irAEs) and non-clear-cell-RCC (nccRCC) histology were assessed using Chi-square test. Results Our cohort was comprised of 38 AA and 160 Caucasian patients. Most were diagnosed with clear-cell-RCC (ccRCC) (78%) and more than half received (57%) PD-1/PD-L1 monotherapy. Most patients were intermediate or poor-risk groups (83%). Comparing to Caucasians, our AA cohort contained more females and nccRCC cases. Kaplan-Meier method showed AAs had no statistically different median OS (17 vs 25 months, p=0.368) and PFS (3.1 vs 4.4 months, p=0.068) relative to Caucasian patients. On multivariable analysis, AA patients had significantly shorter PFS (HR=1.52, 95% CI: 1.01-2.3, p=0.045), similar ORR (OR=1.04, 95% CI: 0.42-2.57, p=0.936) and comparable OS (HR=1.09, 95% CI: 0.61-1.95, p=0.778) relative to Caucasians. Conclusions Our real-world analysis of ICI-treated mRCC patients showed that AAs experienced shorter PFS but similar OS relative to Caucasians. This similarity in survival outcomes is reassuring for the use of ICI amongst real-world patient populations, however, the difference in treatment response is poorly represented in early outcomes data from clinical trials. Thus, the literature requires larger prospective studies to validate these findings.","journal":"Frontiers in Oncology","year":2021,"id":194824,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8569,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":374688,"name":"Dylan J. Martini","orcid":"0000-0002-0843-1222","position":1,"is_corresponding":false},{"id":506614,"name":"Subir Goyal","orcid":"0000-0003-1737-7771","position":2,"is_corresponding":false},{"id":253866,"name":"Yuan Liu","orcid":"0000-0001-8926-3058","position":3,"is_corresponding":false},{"id":682741,"name":"Sean T. Evans","orcid":null,"position":4,"is_corresponding":false},{"id":681904,"name":"Benjamin Magod","orcid":"0009-0007-9044-5845","position":5,"is_corresponding":false},{"id":374690,"name":"Jacqueline T. Brown","orcid":"0000-0002-1885-0906","position":6,"is_corresponding":false},{"id":573777,"name":"Lauren Yantorni","orcid":"0000-0003-0611-7106","position":7,"is_corresponding":false},{"id":375557,"name":"Greta Russler","orcid":null,"position":8,"is_corresponding":false},{"id":375558,"name":"Sarah Caulfield","orcid":null,"position":9,"is_corresponding":false},{"id":681905,"name":"Jamie Goldman","orcid":"0000-0001-8986-3555","position":10,"is_corresponding":false},{"id":374692,"name":"Wayne Harris","orcid":"0000-0002-1032-0265","position":11,"is_corresponding":false},{"id":315130,"name":"Ömer Küçük","orcid":"0000-0002-4755-0507","position":12,"is_corresponding":false},{"id":375560,"name":"Bradley Curtis Carthon","orcid":null,"position":13,"is_corresponding":false},{"id":374693,"name":"Viraj A. Master","orcid":"0000-0002-7251-142X","position":14,"is_corresponding":false},{"id":314615,"name":"Bassel Nazha","orcid":"0000-0001-6385-1329","position":15,"is_corresponding":false},{"id":105141,"name":"Mehmet Asım Bilen","orcid":"0000-0003-4003-1103","position":16,"is_corresponding":false},{"id":642354,"name":"T. Anders Olsen","orcid":"0000-0002-1955-5626","position":0,"is_corresponding":true}],"reference_count":33,"raw_metadata":null,"created_at":"2026-07-18T23:49:59.476757Z","pmid":"34222024","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}