Metastatic sarcomatoid renal cell carcinoma treated with immune checkpoint inhibitors

ABSTRACT Introduction: Renal cell carcinoma (RCC) with sarcomatoid component carries a poor prognosis. Immune checkpoint inhibitors (CPIs) have been approved for the treatment of metastatic RCC, but their efficacy in patients with sarcomatoid component is not known. Materials and Methods: We conducted a retrospective chart review of 30 consecutive patients at our center who were treated for metastatic RCC with sarcomatoid component. Results: Ten patients were treated with CPI group while 20 patients were in No-CPI group. There were no significant differences in age, sex, race, and stage at diagnosis between the two groups. After a median follow-up of 35 months, 3 of 10 patients in CPI arm and 5 of 20 patients in No-CPI group were alive. The median overall survival was 33.8 m in immunotherapy group compared to 8.8 m in nonimmunotherapy group (p = .001). Discussion: In our experience, CPI therapy resulted in better outcomes compared to traditional therapy with molecular-targeted agents or chemotherapy in these patients.

[1]  K. Bensalah,et al.  Updated European Association of Urology Guidelines Recommendations for the Treatment of First-line Metastatic Clear Cell Renal Cancer. , 2017, European urology.

[2]  C. Porta,et al.  CheckMate 214: Efficacy and safety of nivolumab + ipilimumab (N+I) v sunitinib (S) for treatment-naïve advanced or metastatic renal cell carcinoma (mRCC), including IMDC risk and PD-L1 expression subgroups , 2017, Annals of Oncology.

[3]  K. Iczkowski,et al.  Immune Check Point Inhibition in Sarcomatoid Renal Cell Carcinoma: A New Treatment Paradigm , 2017, Clinical genitourinary cancer.

[4]  A. Belldegrun,et al.  Genomic characterization of sarcomatoid transformation in clear cell renal cell carcinoma , 2016, Proceedings of the National Academy of Sciences.

[5]  A. Ravaud,et al.  Nivolumab versus Everolimus in Advanced Renal-Cell Carcinoma. , 2015, The New England journal of medicine.

[6]  T. Ho,et al.  PD-1 and PD-L1 Expression in Renal Cell Carcinoma with Sarcomatoid Differentiation , 2015, Cancer Immunology Research.

[7]  R. Motzer,et al.  Phase II randomized trial comparing sequential first-line everolimus and second-line sunitinib versus first-line sunitinib and second-line everolimus in patients with metastatic renal cell carcinoma. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[8]  R. Motzer,et al.  Overall survival in renal-cell carcinoma with pazopanib versus sunitinib. , 2014, The New England journal of medicine.

[9]  M. Krasnik,et al.  High procedure volume is strongly associated with improved survival after lung cancer surgery. , 2013, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[10]  J. Reeves,et al.  Pazopanib versus sunitinib in metastatic renal-cell carcinoma. , 2013, The New England journal of medicine.

[11]  T. Choueiri,et al.  Combination of antiangiogenic therapy and cytotoxic chemotherapy for sarcomatoid renal cell carcinoma. , 2013 .

[12]  T. Choueiri,et al.  Outcome of metastatic sarcomatoid renal cell carcinoma (sRCC): Results from the International mRCC Database Consortium. , 2013 .

[13]  Rajinder Singh,et al.  Radiological treatment of a spontaneously ruptured inferior adrenal artery aneurysm , 2010, Nature Reviews Urology.

[14]  Wong-Ho Chow,et al.  Epidemiology and risk factors for kidney cancer , 2010, Nature Reviews Urology.

[15]  C. Sternberg,et al.  Pazopanib in Locally Advanced or Metastatic Renal Cell Carcinoma: Results of a Randomized Phase III Trial , 2010, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[16]  Xin Huang,et al.  Overall Survival and Updated Results for Sunitinib Compared With Interferon Alfa in Patients With Metastatic Renal Cell Carcinoma , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[17]  Apurva A Desai,et al.  Sorafenib for treatment of renal cell carcinoma: Final efficacy and safety results of the phase III treatment approaches in renal cancer global evaluation trial. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  Ming Zhou,et al.  Metastatic sarcomatoid renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy. , 2009, Journal of Clinical Oncology.

[19]  R. Motzer,et al.  Efficacy of everolimus in advanced renal cell carcinoma: a double-blind, randomised, placebo-controlled phase III trial , 2008, The Lancet.

[20]  David McDermott,et al.  Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma. , 2007, The New England journal of medicine.

[21]  A. Matsumoto,et al.  DHEA and testosterone in the elderly. , 2007, The New England journal of medicine.

[22]  V. Janout,et al.  Epidemiology and risk factors of kidney cancer. , 2004, Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia.

[23]  S. Culine,et al.  Doxorubicin and ifosfamide in patients with metastatic sarcomatoid renal cell carcinoma: a phase II study of the Genitourinary Group of the French Federation of Cancer Centers. , 2002, The Journal of urology.

[24]  A. Jemal,et al.  Cancer statistics, 2018 , 2018, CA: a cancer journal for clinicians.