{"id":"https://openalex.org/W2947199703","doi":"https://doi.org/10.1200/jco.2019.37.15_suppl.4566","title":"Clinical and economic outcomes associated with sequential treatment in patients with advanced renal cell carcinoma (aRCC).","display_name":"Clinical and economic outcomes associated with sequential treatment in patients with advanced renal cell carcinoma (aRCC).","publication_year":2019,"publication_date":"2019-05-20","ids":{"openalex":"https://openalex.org/W2947199703","doi":"https://doi.org/10.1200/jco.2019.37.15_suppl.4566","mag":"2947199703"},"language":"en","primary_location":{"id":"doi:10.1200/jco.2019.37.15_suppl.4566","doi":"https://doi.org/10.1200/jco.2019.37.15_suppl.4566","is_oa":false,"landing_page_url":"https://doi.org/10.1200/jco.2019.37.15_suppl.4566","pdf_url":null,"source":{"id":"https://openalex.org/S15137598","display_name":"Journal of Clinical Oncology","issn_l":"0732-183X","issn":["0732-183X","1527-7755"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Oncology","raw_type":"journal-article"},"volume":null,"type":"conference-abstract","is_traditional":false,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5017334876","display_name":"Meredith M. Regan","orcid":"https://orcid.org/0000-0002-2428-6109","observed_orcids":["https://orcid.org/0000-0002-2428-6109"]},"institutions":[{"id":"https://openalex.org/I1316535847","display_name":"Beth Israel Deaconess Medical Center","ror":"https://ror.org/04drvxt59","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1316535847"]},{"id":"https://openalex.org/I4210134579","display_name":"Dana-Farber/Harvard Cancer Center","ror":"https://ror.org/03pvyf116","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I136199984","https://openalex.org/I4210117453","https://openalex.org/I4210134579"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Meredith M. Regan","raw_affiliation_strings":["1 Beth Israel Deaconess Medical Center, Dana-Farber/Harvard Cancer Center, Boston, MA;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"1 Beth Israel Deaconess Medical Center, Dana-Farber/Harvard Cancer Center, Boston, MA;","institution_ids":["https://openalex.org/I1316535847","https://openalex.org/I4210134579"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5007052233","display_name":"David F. McDermott","orcid":"https://orcid.org/0000-0002-2675-5095","observed_orcids":["https://orcid.org/0000-0002-2675-5095","https://orcid.org/0000-0001-6978-0867"]},"institutions":[{"id":"https://openalex.org/I1316535847","display_name":"Beth Israel Deaconess Medical Center","ror":"https://ror.org/04drvxt59","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1316535847"]},{"id":"https://openalex.org/I4210134579","display_name":"Dana-Farber/Harvard Cancer Center","ror":"https://ror.org/03pvyf116","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I136199984","https://openalex.org/I4210117453","https://openalex.org/I4210134579"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"David F. McDermott","raw_affiliation_strings":["Beth Israel Deaconess Medical Center, Dana-Farber/Harvard Cancer Center, Boston, MA;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Beth Israel Deaconess Medical Center, Dana-Farber/Harvard Cancer Center, Boston, MA;","institution_ids":["https://openalex.org/I1316535847","https://openalex.org/I4210134579"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5052526230","display_name":"Michael B. Atkins","orcid":"https://orcid.org/0000-0003-3901-9924","observed_orcids":["https://orcid.org/0000-0003-3901-9924"]},"institutions":[{"id":"https://openalex.org/I2799903593","display_name":"Georgetown University Medical Center","ror":"https://ror.org/00hjz7x27","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2799903593"]},{"id":"https://openalex.org/I4390039356","display_name":"Georgetown Lombardi Comprehensive Cancer Center","ror":"https://ror.org/035zrb927","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I184565670","https://openalex.org/I4390039356"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Michael B. Atkins","raw_affiliation_strings":["Georgetown Lombardi Comprehensive Cancer Center, Washington, DC;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Georgetown Lombardi Comprehensive Cancer Center, Washington, DC;","institution_ids":["https://openalex.org/I2799903593","https://openalex.org/I4390039356"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5056195662","display_name":"Apoorva Ambavane","orcid":"https://orcid.org/0000-0001-5887-792X","observed_orcids":["https://orcid.org/0000-0001-5887-792X"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Apoorva Ambavane","raw_affiliation_strings":["Evidera, Inc., Bethesda, MD;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Evidera, Inc., Bethesda, MD;","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5029344404","display_name":"Shuo Yang","orcid":"https://orcid.org/0000-0001-6894-0793","observed_orcids":["https://orcid.org/0000-0001-6894-0793"]},"institutions":[{"id":"https://openalex.org/I4210091812","display_name":"Bristol-Myers Squibb (United States)","ror":"https://ror.org/00gtmwv55","country_code":"US","type":"company","lineage":["https://openalex.org/I4210091812"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Shuo Yang","raw_affiliation_strings":["Bristol-Myers Squibb, Princeton, NJ;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Bristol-Myers Squibb, Princeton, NJ;","institution_ids":["https://openalex.org/I4210091812"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5109110234","display_name":"Sumati A. Rao","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210091812","display_name":"Bristol-Myers Squibb (United States)","ror":"https://ror.org/00gtmwv55","country_code":"US","type":"company","lineage":["https://openalex.org/I4210091812"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Sumati Rao","raw_affiliation_strings":["Bristol-Myers Squibb, Princeton, NJ;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Bristol-Myers Squibb, Princeton, NJ;","institution_ids":["https://openalex.org/I4210091812"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5028789952","display_name":"Marc Dror Michaelson","orcid":"https://orcid.org/0000-0001-9249-6338","observed_orcids":["https://orcid.org/0000-0001-9249-6338"]},"institutions":[{"id":"https://openalex.org/I4210087915","display_name":"Massachusetts General Hospital","ror":"https://ror.org/002pd6e78","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210087915","https://openalex.org/I48633490"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"M Dror Michaelson","raw_affiliation_strings":["Massachusetts General Hospital Cancer Center, Boston, MA;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Massachusetts General Hospital Cancer Center, Boston, MA;","institution_ids":["https://openalex.org/I4210087915"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":6,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"37","issue":"15_suppl","first_page":"4566","last_page":"4566"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10449","display_name":"Renal cell carcinoma treatment","score":0.9071999788284302,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10449","display_name":"Renal cell carcinoma treatment","score":0.9071999788284302,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.06449999660253525,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12708","display_name":"Economic and Financial Impacts of Cancer","score":0.006899999920278788,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/advanced-renal-cell-carcinoma","display_name":"advanced renal cell carcinoma","score":0.9990000128746033},{"id":"https://openalex.org/keywords/treatment-sequencing","display_name":"treatment sequencing","score":0.9679999947547913},{"id":"https://openalex.org/keywords/nivolumab","display_name":"nivolumab","score":0.6579999923706055},{"id":"https://openalex.org/keywords/ipilimumab","display_name":"ipilimumab","score":0.9990000128746033},{"id":"https://openalex.org/keywords/tyrosine-kinase-inhibitors","display_name":"tyrosine kinase inhibitors","score":0.9160000085830688},{"id":"https://openalex.org/keywords/lenvatinib","display_name":"lenvatinib","score":0.7170000076293945},{"id":"https://openalex.org/keywords/everolimus","display_name":"everolimus","score":0.9909999966621399},{"id":"https://openalex.org/keywords/axitinib","display_name":"axitinib","score":0.6980000138282776},{"id":"https://openalex.org/keywords/pazopanib","display_name":"pazopanib","score":0.9129999876022339},{"id":"https://openalex.org/keywords/cabozantinib","display_name":"cabozantinib","score":0.9789999723434448},{"id":"https://openalex.org/keywords/sunitinib","display_name":"sunitinib","score":0.9340000152587891},{"id":"https://openalex.org/keywords/cost-effectiveness","display_name":"cost-effectiveness","score":0.7670000195503235},{"id":"https://openalex.org/keywords/survival","display_name":"survival","score":0.6470000147819519},{"id":"https://openalex.org/keywords/discrete-event-simulation","display_name":"discrete event simulation","score":0.7960000038146973},{"id":"https://openalex.org/keywords/immune-checkpoint-inhibitors","display_name":"immune checkpoint inhibitors","score":0.6010000109672546}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8934344053268433},{"id":"https://openalex.org/C2776539811","wikidata":"https://www.wikidata.org/wiki/Q4830631","display_name":"Axitinib","level":4,"score":0.8446497917175293},{"id":"https://openalex.org/C2780030458","wikidata":"https://www.wikidata.org/wiki/Q7041828","display_name":"Nivolumab","level":4,"score":0.8410769104957581},{"id":"https://openalex.org/C2778439243","wikidata":"https://www.wikidata.org/wiki/Q7157043","display_name":"Pazopanib","level":4,"score":0.8096390962600708},{"id":"https://openalex.org/C2781433595","wikidata":"https://www.wikidata.org/wiki/Q2459042","display_name":"Ipilimumab","level":4,"score":0.7368936538696289},{"id":"https://openalex.org/C2779490328","wikidata":"https://www.wikidata.org/wiki/Q417542","display_name":"Sunitinib","level":3,"score":0.6935824155807495},{"id":"https://openalex.org/C2779699572","wikidata":"https://www.wikidata.org/wiki/Q421052","display_name":"Everolimus","level":2,"score":0.6234641671180725},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.5877845883369446},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.569324254989624},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.4773987829685211},{"id":"https://openalex.org/C2781064419","wikidata":"https://www.wikidata.org/wiki/Q795057","display_name":"Cabozantinib","level":3,"score":0.4482347369194031},{"id":"https://openalex.org/C2777472916","wikidata":"https://www.wikidata.org/wiki/Q1164529","display_name":"Renal cell carcinoma","level":2,"score":0.374309241771698},{"id":"https://openalex.org/C2777701055","wikidata":"https://www.wikidata.org/wiki/Q1427096","display_name":"Immunotherapy","level":3,"score":0.3230525851249695},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.2724769115447998}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1200/jco.2019.37.15_suppl.4566","doi":"https://doi.org/10.1200/jco.2019.37.15_suppl.4566","is_oa":false,"landing_page_url":"https://doi.org/10.1200/jco.2019.37.15_suppl.4566","pdf_url":null,"source":{"id":"https://openalex.org/S15137598","display_name":"Journal of Clinical Oncology","issn_l":"0732-183X","issn":["0732-183X","1527-7755"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Oncology","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9476000070571899,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W3003512643","https://openalex.org/W2970863592","https://openalex.org/W4401363872","https://openalex.org/W4415229192","https://openalex.org/W3031590991","https://openalex.org/W2912487652","https://openalex.org/W2900705321","https://openalex.org/W3200989724","https://openalex.org/W4206532712","https://openalex.org/W3044336467"],"abstract_inverted_index":{"4566":[0],"Background:":[1],"Immuno-oncology":[2],"therapies":[3],"(IOs)":[4],"and":[5,20,41,69,97,122,131,138,155,243],"tyrosine":[6],"kinase":[7],"inhibitors":[8],"(TKIs)":[9],"are":[10],"recommended":[11],"for":[12,48,172],"the":[13,66,118,183,262,265],"treatment":[14,34,46,80,242,255],"of":[15,32,167,186,208,254,264],"aRCC.":[16],"As":[17],"new":[18],"drugs":[19],"combination":[21],"regimens":[22],"emerge,":[23],"there":[24],"is":[25,215],"interest":[26],"in":[27,152],"gaining":[28],"a":[29,123,237],"deeper":[30],"understanding":[31],"optimal":[33],"sequencing.":[35],"We":[36],"aimed":[37],"to":[38,64,148,204,217,240,260],"assess":[39],"clinical":[40],"economic":[42],"outcomes":[43],"associated":[44],"with":[45,52,81,161,176,192,247,251],"sequences":[47,145,160,175,231,256],"untreated":[49],"aRCC":[50],"patients":[51],"IMDC":[53],"intermediate/poor":[54],"risk.":[55],"Methods:":[56],"A":[57],"discrete":[58],"event":[59],"simulation":[60],"model":[61],"was":[62],"developed":[63],"estimate":[65],"total":[67],"costs":[68],"survival":[70,151,198,220,246],"(in":[71],"life-years;":[72],"LYs)":[73],"over":[74],"patients\u2019":[75],"lifetimes":[76],"when":[77],"receiving":[78],"sequential":[79],"nivolumab":[82,98],"+":[83,106],"ipilimumab":[84],"(N+I),":[85],"sunitinib":[86],"(SUN),":[87],"pazopanib":[88],"(PAZ),":[89],"or":[90,104,230],"cabozantinib":[91],"(CAB)":[92],"as":[93,109],"first-line":[94],"(1L)":[95],"treatment,":[96],"(NIVO),":[99],"axitinib":[100],"(AXI),":[101],"PAZ,":[102],"CAB,":[103],"lenvatinib":[105],"everolimus":[107],"(LEN+EVE)":[108],"second":[110],"line":[111],"(2L).":[112],"Efficacy":[113],"inputs":[114],"were":[115,134,146,180],"derived":[116],"from":[117,136],"CheckMate":[119],"214":[120],"trial":[121],"network":[124],"meta-analysis":[125],"based":[126],"on":[127],"available":[128,140],"literature.":[129],"Safety":[130],"cost":[132],"data":[133],"obtained":[135],"literature":[137],"publicly":[139],"sources.":[141],"Results:":[142],"N+I":[143,173,210],"initiating":[144,174],"estimated":[147,216],"provide":[149,218],"longer":[150,219,238,244],"mean":[153,157],"LYs":[154],"lower":[156],"costs/LY":[158,202],"versus":[159,225],"1L":[162,209],"TKIs":[163,226],"(table).":[164],"The":[165],"estimates":[166],"incremental":[168,197],"cost-effectiveness":[169],"ratio":[170],"(ICER)":[171],"2L":[177,189,193,241],"TKI":[178,213],"monotherapy":[179,214],"well":[181],"below":[182],"willingness-to-pay":[184],"threshold":[185],"$50,000.":[187],"Using":[188],"LEN+EVE,":[190],"compared":[191],"monotherapies,":[194],"provided":[195],"an":[196],"gain":[199],"but":[200],"at":[201],"close":[203],"$100,000.":[205],"Conclusions:":[206],"Use":[207],"followed":[211,227],"by":[212,228,236],"while":[221],"being":[222],"more":[223],"cost-effective":[224],"IOs":[229],"cycling":[232],"TKIs,":[233],"mainly":[234],"driven":[235],"time":[239],"treatment-free":[245],"N+I.":[248],"Clinical":[249],"trials":[250],"head-to-head":[252],"comparisons":[253],"would":[257],"be":[258],"necessary":[259],"validate":[261],"findings":[263],"study.":[266],"[Table:":[267],"see":[268],"text]":[269]},"counts_by_year":[],"updated_date":"2026-10-27T15:51:10.671819","created_date":"2019-06-07T00:00:00"}