NDLI: Outcome of patients with metastatic sarcomatoid renal cell carcinoma: results from the International Metastatic Renal Cell Carcinoma Database Consortium.

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Outcome of patients with metastatic sarcomatoid renal cell carcinoma: results from the International Metastatic Renal Cell Carcinoma Database Consortium.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kyriakopoulos, Christos E. Chittoria, Namita Choueiri, Toni K. Kroeger, Nils Lee, Jae-Lyun Srinivas, Sandy Knox, Jennifer J. Bjarnason, Georg A. Ernst, Scott D. Wood, Lori A. Vaishampayan, Ulka N. Agarwal, Neeraj Pal, Sumanta K. Kanesvaran, Ravindran Rha, Sun-Young Yuasa, Takeshi Donskov, Frede North, Scott A. Heng, Daniel Y. Rini, Brian I.
Description	Author Affiliation: Kyriakopoulos CE ( Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH. Electronic address: ckyriakopou@gmail.com.); Chittoria N ( Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.); Choueiri TK ( Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.); Kroeger N ( Department of Urology, University Hospital of Greifswald, Greifswald, Germany.); Lee JL ( Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.); Srinivas S ( Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA.); Knox JJ ( Department of Medicine, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.); Bjarnason GA ( Department of Medical Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.); Ernst SD ( Department of Medical Oncology, Western University, London, Ontario, Canada.); Wood LA ( Department of Medicine and Urology, Queen Elizabeth II Health Sciences Center, Dalhousie University, Halifax, Nova Scotia, Canada.); Vaishampayan UN ( Department of Medical Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI.); Agarwal N ( Department of Medical Oncology, University of Utah Huntsman Cancer Institute, Salt Lake City, UT.); Pal SK ( Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA.); Kanesvaran R ( Department of Medical Oncology, National Cancer Centre Singapore, Singapore.); Rha SY ( Department of Internal Medicine, Yonsei Cancer Center, Yonsei University Health System, Institute for Cancer Research, Yonsei University College of Medicine, Seoul, South Korea.); Yuasa T ( Departments of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.); Donskov F ( Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.); North SA ( Department of Oncology, Cross Cancer Center, University of Alberta, Edmonton, Alberta, Canada.); Heng DY ( Department of Medical Oncology, Tom Baker Cancer Center, University of Calgary, Calgary, Alberta, Canada.); Rini BI ( Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.)
Abstract	BACKGROUND: Sarcomatoid renal cell carcinoma is associated with poor prognosis. Data regarding outcome in the targeted therapy era are lacking. PATIENTS AND METHODS: Clinical, prognostic, and treatment parameters in metastatic renal cell carcinoma patients with and without sarcomatoid histology treated with targeted therapy were retrospectively analyzed. RESULTS: Two thousand two hundred eighty-six patients were identified (sRCC: n = 230 and non-sRCC: n = 2056). sRCC patients had significantly worse IMDC prognostic criteria compared with non-sRCC (11% vs. 19% favorable risk; 49% vs. 57% intermediate risk, and 40% vs. 24% poor risk; P < .0001). Time from original diagnosis to relapse (excluding synchronous metastatic disease) was shorter in the sRCC group (18.8 vs. 42.9 months; P < .0001). There was no significant difference in the incidence of central nervous system metastases (6%-8%) or underlying clear cell histology (87%-88%). More than 93% of patients received VEGF inhibitors as first-line therapy; objective response was less common in sRCC whereas primary refractory disease was more common (21% vs. 26% and 43% vs. 21%; P < .0001, for both). sRCC patients had significantly less use of second- (P = .018) and third-line (P < .0001) systemic therapy. The median progression-free survival (PFS)/overall survival (OS) was 4.5/10.4 months in sRCC patients and 7.8/22.5 months in non-sRCC patients (P < .0001 for both). Sarcomatoid histology was associated with a significantly worse PFS and OS after adjusting for individual IMDC risk factors in multivariable analysis (hazard ratio, 1.5; P < .0001 for both). CONCLUSION: Patients with sRCC have a shorter time to relapse, worse baseline prognostic criteria, and worse clinical outcome with targeted therapy. Additional insight into the biology of sRCC is needed to develop alternative therapeutics.
File Format	HTM / HTML
ISSN	15587673
Issue Number	2
Volume Number	13
e-ISSN	19380682
Journal	Clinical Genitourinary Cancer
Language	English
Publisher	Elsevier
Publisher Date	2015-04-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Urology Discipline Oncology Angiogenesis Inhibitors Therapeutic Use Antineoplastic Agents Carcinoma, Renal Cell Drug Therapy Kidney Neoplasms Neoplasm Recurrence, Local Pathology Databases, Factual Humans Molecular Targeted Therapy Neoplasm Metastasis Retrospective Studies Treatment Outcome Vascular Endothelial Growth Factor A Antagonists & Inhibitors Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Urology Oncology

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