Sarcomatoid-variant renal cell carcinoma: Treatment outcome and survival in advanced disease Journal Article
| Authors: | Molina, A. M.; Tickoo, S. K.; Ishill, N.; Trinos, M. J.; Schwartz, L. H.; Patil, S.; Feldman, D. R.; Reuter, V. E.; Russo, P.; Motzer, R. J. |
| Article Title: | Sarcomatoid-variant renal cell carcinoma: Treatment outcome and survival in advanced disease |
| Abstract: | OBJECTIVES: Sarcomatoid variant is a spindle cell phenotype of renal cell carcinoma (RCC), which is associated with a poor prognosis. We reviewed outcomes of systemic therapy for metastatic, sarcomatoid-variant RCC. METHODS: Clinical features, treatment outcome, and survival were evaluated in 63 patients with sarcomatoid-variant metastatic RCC (47 clear cell, 16 nonclear cell). Initial systemic treatment included antiangiogenesis-targeted therapy (n=34), cytokines (n=20), and chemotherapy (n=9). RESULTS: Five of 63 patients (8%) achieved an objective response to the first systemic treatment: 1 (5%) to cytokine and 4 (12%) to sunitinib-targeted therapy. Median progression-free survival for 63 patients was 3 months (95% confidence interval), and median overall survival was 10 months (95% confidence interval). The median progression-free survival for patients treated with sunitinib versus all others was 4.4 months versus 2 months (P=0.03), and 3 months for patients with clear-cell histology versus 1.6 months for nonclear-cell histology (P=0.004). CONCLUSIONS: Metastatic sarcomatoid-variant RCC was associated with a poor response to systemic therapy. Sunitinib treatment resulted in a modest response rate, but studies to characterize the underlying tumor biology of sarcomatoid-variant RCC, to assess outcome to targeted agents, and to develop novel treatment strategies are warranted. Copyright © 2011 by Lippincott Williams & Wilkins. |
| Keywords: | immunohistochemistry; adult; cancer chemotherapy; cancer survival; human tissue; protein expression; treatment outcome; treatment response; aged; aged, 80 and over; bone neoplasms; middle aged; survival rate; retrospective studies; major clinical study; overall survival; clinical feature; sorafenib; bevacizumab; sunitinib; advanced cancer; systemic therapy; liver neoplasms; alpha interferon; gemcitabine; follow-up studies; lymphatic metastasis; interleukin 2; cancer immunotherapy; metastasis; progression free survival; bortezomib; cohort studies; antineoplastic combined chemotherapy protocols; lung neoplasms; carcinoma, papillary; cetuximab; renal cell carcinoma; kidney carcinoma; kidney neoplasms; docetaxel; temsirolimus; survival time; carbonate dehydratase ix; carcinoma, renal cell; gefitinib; antiangiogenic therapy; initiation factor 4e binding protein 1; targeted therapy; clear cell carcinoma; sarcomatoid; hypoxia inducible factor 1alpha; everolimus; phosphoprotein; metastatic; geldanamycin; protein s6; kidney sarcoma; sarcomatoid variant kidney carcinoma |
| Journal Title: | American Journal of Clinical Oncology: Cancer Clinical Trials |
| Volume: | 34 |
| Issue: | 5 |
| ISSN: | 0277-3732 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2011-10-01 |
| Start Page: | 454 |
| End Page: | 459 |
| Language: | English |
| DOI: | 10.1097/COC.0b013e3181f47aa4 |
| PROVIDER: | scopus |
| PUBMED: | 21127411 |
| PMCID: | PMC3661202 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 November 2011" - "CODEN: AJCOD" - "Source: Scopus" |
