Patients with sarcomatoid renal cell carcinoma face poor prognosis despite targeted therapy
Despite treatment with nephrectomy and systemic therapy in the cytokine and targeted therapy eras, overall survival and prognosis remain poor among patients with sarcomatoid renal cell carcinoma, with no clear long-term benefit of targeted therapy, according to a recent study.
Researchers conducted a retrospective study of patients with sarcomatoid renal cell carcinoma who underwent nephrectomy and received systemic therapy at a centre in the cytokine era (1987 to 2005) or the targeted therapy era (2006 to 2015). They used multivariate regression models to determine the association of covariables with survival.
A total of 167 (83.9 percent) out of 199 patients with sarcomatoid renal cell carcinoma died (median overall survival, 16.5 months; 95 percent CI, 15.2 to 20.9).
Patients with clear cell histology had significantly longer survival compared with those with nonclear cell histology (p=0.034). Survival was significantly shorter in patients with synchronous metastatic disease than in those with metachronous metastatic disease (median, 12.1 vs 23.3 months; p=0.0064).
Furthermore, the presence of sarcomatoid features can be detected by biopsy of the primary tumours or a metastatic site in only 7.5 percent of cases.
There was a significant improvement in survival rate seen in the first year in patients treated in the targeted therapy era (p=0.011), but this effect was attenuated at year 2, disappeared at years 3 to 5 after diagnosis, and was not evident in patients with poor risk features.
“This underscores the need to develop more effective systemic therapies for these patients,” according to researchers.