Comparison of IO-TKI vs IO-IO combinations in IMDC poor-risk metastatic renal cell carcinoma (mRCC) patients (Meet-URO 33 analysis).

• DOI: 10.1200/jco.2025.43.5_suppl.495
• Publication Date: 2025-02-18T14:43:07Z
• Authors: Sara Elena Rebuzzi; Alessio Signori; Sebastiano Buti; Alberto Dalla Volta; Martina Fanelli; Valeria Sardaro; Marilena Di Napoli; Cristina Masini; Annalisa Guida; Roberto Filippi; Silvia Chiellino; Carlo Messina; Sarah Scagliarini; Emanuela Fantinel; Lucia Bonomi; Vincenza Conteduca; Filippo Maria Dep...; Mariella Sorarù; Giuseppe Fornarini; Davide Bimbatti

495 Background: Immune-combinations have become the cornerstone of mRCC treatment landscape, but head-to-head comparisons between different first-line strategies are lacking and few real-world data available in this setting. In context, little evidence is available, especially for IMDC poor-risk patients, who worst prognosis lowest response to standard treatments. Methods: The Meet-URO 33 study an Italian retrospective/prospective registry setting patients from January 2021 (Trial registration: CESC IOV 2023-78, PMID: 38914928) with aim answer as many clinical questions possible. This analysis focused on assessing performance IO-TKI IO-IO combinations terms survival outcomes differential baseline characteristics two groups. Results: Among 892 enrolled 40 centres, 772 (87%) were evaluable analyses; 160 (21%) had poor risk: 42 (26%) received IO-IO, 105 (66%) 13 (8%) TKI. Comparing included immune-combinations, receiving older (mean age: 68 vs 64, p=0.03), more cardiovascular comorbidities (74% 56%, p=0.048) lower frequency bone metastases (29% 57%, p=0.002). After a mFUP 6.9 months (mo), mOS all was 11.3 months, higher than [20.6 11 mo, HR 1.65 (0.97-2.82); p=0.067]. multivariable (age, comorbidities, ECOG, metastases) difference not statistically significant [HR 1.37 (0.78-2.40); p=0.27]. overall mPFS 6.4 compared [11 5.8 1.70 (1.05-2.75); p=0.031]. analysis, groups lost statistical significance 1.58 (0.95-2.63); p=0.078]. general ORR 46%, [71% 29%, OR 0.70 (0.21-1.56); p=0.38]. Conclusions: These preliminary analyses ongoing show no clear advantage using instead combination patients. results line well-known smaller benefit TKI (more immunogenic / less angiogenic patterns COSMIC-313 study). A longer follow-up needed examine depth immune-combinations Clinical trial information: 2023-78 .