MDACC 2018: Systemic Therapy for Metastatic Non-Clear Cell Histology Patients: What Works and What Doesn’t?

Houston, TX ( Dr. Pavlos Msaouel focused on when to choose chemotherapy versus targeted therapy in non-clear cell histology, which was summarized in the slide provided below. 

MDACC 2018 UroToday Systemic Therapy for Metastatic Non Clear Cell Histology Patients What Works and What Doesnt
The bottom line is that Anti-VEGF TKIs (Sunitinib, Pazopanib, Axitinib, Cabozanitinib) are a reasonable first-line or salvage options in non-clear cell RCCs with Sunitinib being the preferred option based on the ASPEN 1, ESPN 2 and RECORD-3 trial 3.  Temsirolimus can be considered in poor risk patients and Bevacizumab plus Everolimus is another potential first-line option, especially in tumors with papillary features.   Finally, patients with non-clear cell RCC should be considered for clinical trials for systemic therapy.  

Presented by: Pavlos Msaouel, MD, Ph.D., Department of Genitourinary Medical Oncology, Division of Cancer Medicine Division, MD Anderson Cancer Center

Written by Dr. Amy H. Lim, MD, PhD, Urologic Oncology Fellow and Ashish M. Kamat, MD,(@UroDocAsh), Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX at the 13th Update on the Management of Genitourinary Malignancies, The University of Texas (MDACC - MD Anderson Cancer Center) November 9-10, 2018, Dan L. Duncan Building, Houston, TX

1. Armstrong AJ, Halabi S, Eisen T, Broderick S, Stadler WM, Jones RJ, et al. Everolimus versus sunitinib for patients with metastatic non-clear cell renal cell carcinoma (ASPEN): a multicentre, open-label, randomised phase 2 trial. Lancet Oncol. 2016;17(3):378-88.
2. Tannir NM, Jonasch E, Albiges L, Altinmakas E, Ng CS, Matin SF, et al. Everolimus Versus Sunitinib Prospective Evaluation in Metastatic Non-Clear Cell Renal Cell Carcinoma (ESPN): A Randomized Multicenter Phase 2 Trial. Eur Urol. 2016;69(5):866-74.
3. Motzer RJ, Barrios CH, Kim TM, Falcon S, Cosgriff T, Harker WG, et al. Phase II randomized trial comparing sequential first-line everolimus and second-line sunitinib versus first-line sunitinib and second-line everolimus in patients with metastatic renal cell carcinoma. J Clin Oncol. 2014;32(25):2765-72.