Characterizing the outcomes of metastatic papillary renal cell carcinoma

Outcomes of metastatic papillary renal cell carcinoma (pRCC) patients are poorly characterized in the era of targeted therapy. A total of 5474 patients with metastatic renal cell carcinoma (mRCC) in the International mRCC Database Consortium (IMDC) were retrospectively analyzed. Outcomes were compared between clear cell (ccRCC; n = 5008) and papillary patients (n = 466), and recorded type I and type II papillary patients (n = 30 and n = 165, respectively). Overall survival (OS), progression‐free survival (PFS), and overall response rate (ORR) favored ccRCC over pRCC. OS was 8 months longer in ccRCC patients and the hazard ratio of death was 0.71 for ccRCC patients. No differences in PFS or ORR were detected between type I and II PRCC in this limited dataset. The median OS for type I pRCC was 20.0 months while the median OS for type II was 12.6 months (P = 0.096). The IMDC prognostic model was able to stratify pRCC patients into favorable risk (OS = 34.1 months), intermediate risk (OS = 17.0 months), and poor‐risk groups (OS = 6.0 months). pRCC patient outcomes were inferior to ccRCC, even after controlling for IMDC prognostic factors. The IMDC prognostic model was able to effectively stratify pRCC patients.

[1]  T. Powles,et al.  Cabozantinib versus everolimus in advanced renal cell carcinoma (METEOR): final results from a randomised, open-label, phase 3 trial. , 2016, The Lancet. Oncology.

[2]  P. Tamboli,et al.  Everolimus Versus Sunitinib Prospective Evaluation in Metastatic Non-Clear Cell Renal Cell Carcinoma (ESPN): A Randomized Multicenter Phase 2 Trial. , 2016, European urology.

[3]  J. Hainsworth,et al.  Everolimus versus sunitinib for patients with metastatic non-clear cell renal cell carcinoma (ASPEN): a multicentre, open-label, randomised phase 2 trial. , 2016, The Lancet. Oncology.

[4]  Steven J. M. Jones,et al.  Comprehensive Molecular Characterization of Papillary Renal-Cell Carcinoma. , 2016, The New England journal of medicine.

[5]  A. Ravaud,et al.  First-line treatment with sunitinib for type 1 and type 2 locally advanced or metastatic papillary renal cell carcinoma: a phase II study (SUPAP) by the French Genitourinary Group (GETUG)†. , 2015, Annals of oncology : official journal of the European Society for Medical Oncology.

[6]  I. Tannock,et al.  Systemic therapy for non-clear cell renal cell carcinomas: a systematic review and meta-analysis. , 2015, European urology.

[7]  T. Powles,et al.  395 cMet: Proof-of-concept clinical trial with volitinib in patients with advanced papillary renal cell cancer (PRCC) , 2014 .

[8]  G. Freeman,et al.  PD-L1 expression in nonclear-cell renal cell carcinoma. , 2014, Annals of oncology : official journal of the European Society for Medical Oncology.

[9]  N. Rioux-Leclercq,et al.  MET Is a Potential Target across All Papillary Renal Cell Carcinomas: Result from a Large Molecular Study of pRCC with CGH Array and Matching Gene Expression Array , 2014, Clinical Cancer Research.

[10]  R. Motzer,et al.  Treatment outcome with mTOR inhibitors for metastatic renal cell carcinoma with nonclear and sarcomatoid histologies. , 2014, Annals of oncology : official journal of the European Society for Medical Oncology.

[11]  C. Porta,et al.  Open-label, phase II raptor study of everolimus (EVE) for papillary mRCC: Efficacy in type 1 and type 2 histology. , 2014 .

[12]  T. Choueiri,et al.  Metastatic non–clear cell renal cell carcinoma treated with targeted therapy agents: Characterization of survival outcome and application of the International mRCC Database Consortium criteria , 2013, Cancer.

[13]  Y. Koh,et al.  Phase II trial of everolimus for the treatment of nonclear-cell renal cell carcinoma. , 2013, Annals of oncology : official journal of the European Society for Medical Oncology.

[14]  Keith T Flaherty,et al.  Phase II and biomarker study of the dual MET/VEGFR2 inhibitor foretinib in patients with papillary renal cell carcinoma. , 2013, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[15]  J. Ahn,et al.  Multicenter phase II study of sunitinib in patients with non-clear cell renal cell carcinoma. , 2012, Annals of oncology : official journal of the European Society for Medical Oncology.

[16]  V. Reuter,et al.  Phase II trial of sunitinib in patients with metastatic non-clear cell renal cell carcinoma , 2012, Investigational New Drugs.

[17]  J. Cheville,et al.  Histological subtype is an independent predictor of outcome for patients with renal cell carcinoma. , 2010, The Journal of urology.

[18]  J. Hajdenberg,et al.  Safety and efficacy results of the advanced renal cell carcinoma sorafenib expanded access program in North America , 2010, Cancer.

[19]  Wanling Xie,et al.  Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[20]  Paul Russo,et al.  Prognostic impact of histological subtype on surgically treated localized renal cell carcinoma. , 2009, The Journal of urology.

[21]  C. Porta,et al.  Safety and efficacy of sunitinib for metastatic renal-cell carcinoma: an expanded-access trial. , 2009, The Lancet. Oncology.

[22]  R. Figlin,et al.  Effect of temsirolimus versus interferon-α on outcome of patients with advanced renal cell carcinoma of different tumor histologies , 2009, Medical oncology.

[23]  Amnon Zisman,et al.  Cytogenetic and Molecular Tumor Profiling for Type 1 and Type 2 Papillary Renal Cell Carcinoma , 2009, Clinical Cancer Research.

[24]  C. Elie,et al.  Survival analysis of 130 patients with papillary renal cell carcinoma: prognostic utility of type 1 and type 2 subclassification. , 2007, Urology.

[25]  N. Rioux-Leclercq,et al.  Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[26]  Y. Chrétien,et al.  Prognostic factors for the survival of patients with papillary renal cell carcinoma: meaning of histological typing and multifocality. , 2003, The Journal of urology.

[27]  J. Cheville,et al.  Comparisons of Outcome and Prognostic Features Among Histologic Subtypes of Renal Cell Carcinoma , 2003, The American journal of surgical pathology.

[28]  R. Motzer,et al.  Treatment outcome and survival associated with metastatic renal cell carcinoma of non-clear-cell histology. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[29]  Antonio Lopez-Beltran,et al.  Understanding pathologic variants of renal cell carcinoma: distilling therapeutic opportunities from biologic complexity. , 2015, European urology.

[30]  L. Schwartz,et al.  New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). , 2009, European journal of cancer.

[31]  A. Ravaud,et al.  Efficacy of sunitinib and sorafenib in metastatic papillary and chromophobe renal cell carcinoma. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[32]  M. Kattan,et al.  Effect of papillary and chromophobe cell type on disease-free survival after nephrectomy for renal cell carcinoma , 2006, Annals of Surgical Oncology.

[33]  A. Wolff Systemic therapy , 2001, Current opinion in oncology.