Targeted literature review of outcomes to initial systemic therapy for advanced/metastatic non-clear cell renal cell carcinoma in observational studies Review


Authors: Calhoun, S. R.; Sharma, M.; Lee, C. H.
Review Title: Targeted literature review of outcomes to initial systemic therapy for advanced/metastatic non-clear cell renal cell carcinoma in observational studies
Abstract: Background: Non-clear cell renal cell carcinoma (nccRCC) is a diverse group of cancers that occurs in approximately 25% of patients with renal cell carcinoma. In the advanced/metastatic setting, survival in all nccRCC subtypes is considered poor, due to the inherent aggressiveness of these cancers, and a lack of effective systemic treatment options. Clinical trials of immune/targeted agents have predominantly focused on patients with ccRCC. There is no globally accepted standard of care for nccRCC; however, recently clinical trials have been initiated in this population. Objective: To perform a targeted literature review of published original observational studies reporting common real-world clinical outcomes (real-world overall response rate [rwORR], real-world progression free survival [rwPFS], real-world overall survival [rwOS]) in previously treatment naïve patients with advanced/metastatic nccRCC. Methods: A targeted search of MEDLINE and EMBASE was conducted per PRISMA guidelines to identify observational studies in previously treatment naïve patients with advanced/metastatic nccRCC. Publications with adequate information since 2010 and from select conferences since 2020 were considered. Results: 27 studies across 29 publications were identified. Sample sizes ranged from 7-1,573 across these studies with differences in nccRCC subtypes included and treatments received. Real-world ORR ranged from 0-37%, median rwPFS from 2-17 months, and median rwOS from 3-30 months, across 19, 17, and 24 studies, respectively. These outcomes also varied with receipt/type of treatment and demographic/clinical subgroups with outcomes tending to be worse in patients with papillary RCC compared to chromophobe RCC. Conclusions: Clinical outcomes varied, as patient populations, eligible histologies, treatments and methods were heterogeneous. © 2023 - The authors. Published by IOS Press.
Keywords: adult; cancer survival; survival rate; histopathology; review; sunitinib; advanced cancer; systemic therapy; cancer patient; progression free survival; renal cell carcinoma; protein tyrosine kinase inhibitor; temsirolimus; health care quality; systematic review; pazopanib; mammalian target of rapamycin inhibitor; sample size; clear cell renal cell carcinoma; progression-free survival; clinical outcome; papillary renal cell carcinoma; overall response rate; chromophobe renal cell carcinoma; immune checkpoint inhibitor; response evaluation criteria in solid tumors; human; male; female; review literature; preferred reporting items for systematic reviews and meta-analyses
Journal Title: Kidney Cancer
Volume: 7
Issue: 1
ISSN: 2468-4562
Publisher: IOS Press  
Date Published: 2023-10-10
Start Page: 123
End Page: 136
Language: English
DOI: 10.3233/kca-230008
PROVIDER: scopus
DOI/URL:
Notes: Review -- Source: Scopus
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  1. Chung-Han   Lee
    157 Lee