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
Notes: --- - "Export Date: 2 November 2011" - "CODEN: AJCOD" - "Source: Scopus"
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MSK Authors
  1. Sujata Patil
    366 Patil
  2. Paul Russo
    443 Russo
  3. Robert Motzer
    709 Motzer
  4. Lawrence H Schwartz
    276 Schwartz
  5. Satish K Tickoo
    367 Tickoo
  6. Darren Richard Feldman
    165 Feldman
  7. Ana Maria Luisa Molina
    41 Molina
  8. Victor Reuter
    890 Reuter
  9. Nicole Marie Leoce
    84 Leoce
  10. Michael Joseph Trinos
    6 Trinos