Bone metastasis is associated with poor prognosis in metastatic papillary renal cell carcinoma patients treated with first agent angiogenesis inhibitors.

Papillary renal cell carcinoma (papRCC) is a rare (10%-15%) subtype of renal cancer. Few prognostic biomarkers have been described in metastatic papRCC (m-papRCC) patients treated with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs). We aimed to study the prognostic impact of bone metastases (BM) on response rate, progression-free and overall survival (PFS and OS) in patients with m-papRCC treated with first agent VEGFR-TKIs.

A multicentric, retrospective analysis of patient records was conducted. BM were detected by computed tomography and/or bone scintigraphy. The International Metastatic RCC Database Consortium (IMDC) score was calculated at start of first agent VEGFR-TKI treatment.

Forty-nine patients were included. Best objective response was partial response in 20%, stable disease in 60% and early progressive disease in 20% of patients. Median PFS (mPFS) was 6.0 months and median OS (mOS) 14.0 months after start of first agent VEGFR-TKI. The IMDC score correlated with mOS: 77.5 months in good, 17.0 months in intermediate and 8.0 months in poor risk patients (P = 0.002). Patients with BM had a poorer outcome compared to patients without BM: mPFS was 4.0 vs. 7.0 months (P = 0.006) and mOS 7.5 vs. 19.0 months (P = 0.002). On bivariate analysis, the presence of BM was independently associated with PFS (P = 0.02) and OS (P = 0.049), independent of the IMDC risk groups.

In m-papRCC patients treated with first agent VEGFR-TKIs, the presence of BM is an unfavorable prognostic factor, associated with shorter PFS and OS.

Urologic oncology. 2020 May 17 [Epub ahead of print]

Lorenz Haaker, Loesia Tryssesoone, Inne Renders, Annelies Verbiest, Evelyne Lerut, Marcella Baldewijns, Claire Bourgain, Eduard Roussel, Heidi Van den Bulck, Wim Wynendaele, Brigitte Laguerre, Nathalie Rioux-Leclercq, Stéphane Oudard, Annouschka Laenen, Philip R Debruyne, Maarten Albersen, Benoit Beuselinck

Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium., Department of Pathology, University Hospitals Leuven, Leuven, Belgium., Department of Pathology, Imelda Ziekenhuis, Bonheiden, Belgium., Department of Urology, University Hospitals Leuven, Leuven, Belgium., Department of Medical Oncology, Imelda Ziekenhuis, Bonheiden, Belgium., Department of Medical Oncology, Centre Eugène Marquis, Rennes, France., Department of Pathology, CHU de Rennes, Rennes, France., Department of Medical Oncology, Georges Pompidou European Hospital, Paris, France., Biostatistics and Statistical Bioinformatics Center, Leuven, Belgium., Department of Medical Oncology, AZ Groeninge, Kortrijk, Belgium; Faculty of Health, Education, Medicine & Social Care, Anglia Ruskin University, Chelmsford, United Kingdom., Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium. Electronic address: .