Association of race with clinical outcomes in patients with advanced renal cell carcinoma (aRCC) treated with immune checkpoint inhibitors (ICIs).

e16539 Background: Race has been regarded to be associated with clinical outcome of aRCC patients undergoing therapy with ICIs, but larger data is still limited. Here, we evaluated race and clinical outcome in aRCC patients treated with ICI. Methods: A retrospective analysis was conducted on adult patients with aRCC treated with ICIs at Emory Winship Cancer Institute between 1/1/2018 and 8/31/23. Overall survival (OS) and progression-free survival (PFS) was calculated from the date of treatment initiation to death and progression, respectively. Progression was determined by RECIST v1.1 or clinical progression. Clinical benefit (CB), including stable disease, partial response, and complete response, was determined by RECIST v.1.1. Univariate (UVA) and multivariate (MVA) analyses were conducted for CB, OS, and PFS in patients to assess the association with race. Results: There was a total of 401 patients, consisted of 71.1% White patients, 21.2% African American patients, and 7.7% patients with other racial profiles. Median age was 66 (range = 18-95). Treatment plan involved 139 (34.6%) patients for single ICI therapy, 131 (32.6%) patients for ICI/ICI therapy, 108 (26.9%) patients for ICI/TKI (tyrosine kinase inhibitor) therapy, 6 (1.5%) patients for ICI/ICI/TKI therapy, and 17 (4.23%) patients for therapy with ICI plus an experimental drug. Race was significantly associated with the CB, OS, and PFS of the patients in the UVA. African American patients demonstrated worse clinical outcomes with hazard ratios (HR) significantly less than 1 for both OS and PFS and odds ratios (OR) significantly greater than 1 for CB. According to the Kaplan-Meier plots, the median OS for African American and White patients were 17.1 and 34.8 months, respectively. Similarly, median PFS for African American, White, and patients of other races were 3.6, 7.7, and 13.9, respectively. MVA also suggested greater clinical benefit for patients of White and other racial backgrounds when compared to African American patients. Conclusions: The significant difference in clinical outcomes between the racial profile of patients suggest that African American patients may have worse clinical outcomes in treatment involving ICIs. A more in-depth analysis of race’s association with clinical outcomes can be conducted to assist with treatment plan decisions in the future. [Table: see text]