Metastatic renal cell carcinoma with sarcomatoid histology (SmRCC) is associated with poor survival.
No data is available from randomized trials on the efficacy of vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) inhibitors in SmRCC. We identified SmRCC patients from a single institutional database. To identify predictive and prognostic biomarkers, immunohistochemistry (IHC) analysis was performed on the tumor samples for downstream targets of VEGF and mTOR pathways. Survival outcomes were stratified by IHC analysis, extent of sarcomatoid component, Memorial Sloan-Kettering Cancer Center (MSKCC), and Heng risk criteria. Twenty-seven patients with SmRCC were included. First line therapy included targeted therapy (n = 19), immunotherapy (n = 4), cytotoxic chemotherapy (n = 1), and no treatment (n = 3). Median OS was 8.2 months (95% CI 3.8-14.2 months). Median survival in months, based on MSKCC and Heng risk groups, was favorable 89.3 versus 84.5, intermediate 9.5 versus 12.7, and poor 3.9 versus 5.1. None of the IHC markers predicted outcomes of treatment with VEGF or mTOR inhibitors. Only tumor IMP3 expression was associated with inferior OS, although not statistically significant (IMP3 negative 14.2 versus IMP3 positive 4.9 months; HR 0.46, 95% CI 0.16-1.21; P = 0.12). The study was limited by small sample size.
Written by:
Tantravahi SK, Albertson D, Agarwal AM, Ravulapati S, Poole A, Patel SB, Hawatmeh JS, Straubhar AM, Liu T, Stenehjem DD, Agarwal N. Are you the author?
Department of Internal Medicine, University of Utah Huntsman Cancer Institute, Salt Lake City, UT 84112, USA; ARUP Laboratories, Department of Pathology, The University of Utah, Salt Lake City, UT 84108, USA; Pharmacotherapy Outcomes Research Center (PORC), College of Pharmacy, The University of Utah, Salt Lake City, UT 84112, USA.
Reference: J Oncol. 2015;2015:181926.
doi: 10.1155/2015/181926
PubMed Abstract
PMID: 25688268