Metastatic chromophobe renal cell carcinoma treated with targeted therapies: A Renal Cross Channel Group study

Colomba, Emeline; Teuff, Gwénaël Le; Eisen, Tim; Stewart, Grant D.; Fife, Kate; Larkin, James; Biondo, Andrea; Pickering, Lisa; Srinivasan, AV; Boyle, Helen; Derosa, Lisa; Sternberg, Cora N.; Recine, Federica; Ralph, Christy; Saldana, Carolina; Barthélémy, Philippe; Bernhard, Jean-Christophe; Verhoest, G.; Vauléon, Élodie; Bigot, Pierre; Berger, J.; Pfister, Christian; Gravis, Gwénaëlle; Rodier, Jean-Michel; Culine, Stéphane; Caty, Armelle; Rolland, Frédéric; Priou, Franck; Escudier, Bernard; Albigès, Laurence

doi:10.1016/j.ejca.2017.03.011

Cited by 18 publications

(10 citation statements)

References 27 publications

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“…We analyzed OS according to the different histologic subtypes. Papillary and chromophobe tumors reached the best outcome, as reported in previous studies [3,6,8,19]. Unclassified and sarcomatoid carcinomas had a poor prognosis.…”

Section: Discussionsupporting

confidence: 81%

Real-World Outcome of 173 Metastatic Non-Clear Cell Renal Cell Carcinoma (nccRCC) Cases: The Experience of the Center Group for Genitourinary Tumors

Martín

Puente

Pinto

et al. 2019

KCA

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Non-clear cell renal cell carcinoma (nccRCC) represents a group of multiple histologic subtypes, with different clinical outcomes and an uncertain optimal treatment. Data collected in clear cell tumors are routinely extrapolated to nccRCC, despite a different underlying biology. The Center Group for Genitourinary tumors is a network of medical oncologists from hospitals in Madrid and surrounding provinces that are focused on genitourinary tumors. A retrospective, multicenter study of the outcome of patients with nccRCC diagnosed and treated at the Center Group hospitals between 1995 and 2015 was performed. Baseline clinical features, histologic subtypes, therapeutic management and survival status were analyzed. Data was collected from 173 patients, with a median age at diagnosis of 65 years [24-90], 67.1% were male. Histologic subtypes comprised 55.5% papillary carcinoma, 23.1% sarcomatoid, 13.9% chromophobe, 6.9% unclassified tumors and 0.6% oncocytoma. 159 patients received first line therapy including tyrosine kinase inhibitors (67.9%) and mammalian target of rapamycin inhibitors (11.9%). The response rates (RR) in evaluable patients (142) were: complete response 5.6%, partial response 17.6%, stable disease 40.8% and progression in 35.9% of cases. 90 patients (52.0%) received second line treatment. At the time of the data cutoff point (April 1, 2016), 126 patients had died, with a median overall survival (OS) of 17.9 months [95% CI 15.0-20.9]. The clinical outcome reported in this study has a similar OS to other published studies. Nevertheless, there are substantial differences among the distinct subtypes. Overall, prognosis in nccRCC remains poor. No significant differences were observed in the activity of systemic agents, used as either first or second line therapy.

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Section: Discussionsupporting

confidence: 81%

Real-World Outcome of 173 Metastatic Non-Clear Cell Renal Cell Carcinoma (nccRCC) Cases: The Experience of the Center Group for Genitourinary Tumors

Martín

Puente

Pinto

et al. 2019

KCA

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“…And the only data available to date is from retrospective cohorts studies (Table 3). A retrospective study evaluating TKI efficacy in 45 ChRCC patients (65% were treated with sunitinib, 8% with sorafenib, 3% with pazopanib), exhibited a encouraging response rate of almost 30% [39]. These results were consistent with those found in another retrospective study, in which 10 patients treated with cabozantinib reported a treatment response rate of 30%.…”

Section: Clinical Datasupporting

confidence: 85%

Non-clear cell renal carcinomas: Review of new molecular insights and recent clinical data

Barthélémy

Rioux‐Leclercq

Thibault

et al. 2021

Cancer Treatment Reviews

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Non-clear cell renal cell carcinomas (nccRCC) represent a highly heterogeneous group of kidney tumors, consisting of the following subtypes: papillary carcinomas, chromophobe renal cell carcinoma, so-called unclassified carcinomas or aggressive uncommon carcinomas such as Bellini carcinoma, renal cell carcinoma (RCC) with ALK rearrangement or fumarate hydratase-deficient RCC. Although non-clear cell cancers account for only 15 to 30% of renal tumors, they are often misclassified and accurate diagnosis continues to be an issue in clinical practice. Current therapeutic strategy of metastatic nccRCC is based primarily on guidelines established for clear cell tumors, the most common subtype, however this approach remains poorly defined. To date, published clinical trials for all histological nccRCC subtypes have been collectively characterized into one group, in contrast to clear-cell RCC, and given the small numbers of cases, the interpretation of study results continues to be challenging. This review summarizes the available literature for each nccRCC subtype and highlights the lack of supportive evidence from prospective clinical trials and retrospective studies. Future trials should evaluate treatment approaches which focus on a specific histological subtype and progress in treating nccRCC will be contingent on understanding the unique biology of their individual histologies.

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“…ChRCC came to a similar conclusion [23]. Immunotherapy has also recently emerged as another option to treat metastatic RCC, and clinical trials that compare TKI therapy vs. immunotherapy are currently underway, although these studies have only enrolled patients with ccRCC [24].…”

Section: Case Reports In Urologymentioning

confidence: 92%

Exceptional Response of Metastatic Chromophobe Renal Cell Carcinoma to Vascular Endothelial Growth Factor (VEGF) Inhibitors: Should Increased VEGF-C Expression Be Used to Guide Treatment?

Bruinius

Dykema

Noyes

et al. 2019

Case Reports in Urology

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There is sparse literature demonstrating effective treatments for metastatic chromophobe renal cell carcinoma (ChRCC). The tyrosine kinase inhibitor (TKI) sunitinib selectively inhibits the VEGF pathway and it is a standard care for metastatic clear cell renal cell carcinoma (ccRCC), although data supporting its use in ChRCC is much more limited. A 56-year-old underwent palliative nephrectomy for locally-advanced ChRCC with sarcomatoid differentiation. Tumor gene expression profiling using Affymetrix HG-U133 Plus 2.0 GeneChip platform demonstrated significantly elevated VEGF-C expression compared to normal renal tissue n=12 and other types RCC n=158. Adjuvant sunitinib was used to treat his residual unresectable retroperitoneal lymph nodes. He demonstrated an exceptional response and underwent complete surgical resection four months later. He has been managed with TKIs for nearly nine years with only minimal disease progression. Additional studies exploring treatment options for patients with non-clear cell RCC are needed; in their absence, we would recommend TKIs for patients whose tumors bear a similar molecular profile.

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Metastatic chromophobe renal cell carcinoma treated with targeted therapies: A Renal Cross Channel Group study

Abstract: We report the largest retrospective cohort of patients with mChRCC treated with TT and no significant difference between AA and mTOR inhibitors was observed for TTF and OS.

Cited by 18 publications

References 27 publications

Real-World Outcome of 173 Metastatic Non-Clear Cell Renal Cell Carcinoma (nccRCC) Cases: The Experience of the Center Group for Genitourinary Tumors

Real-World Outcome of 173 Metastatic Non-Clear Cell Renal Cell Carcinoma (nccRCC) Cases: The Experience of the Center Group for Genitourinary Tumors

Non-clear cell renal carcinomas: Review of new molecular insights and recent clinical data

Exceptional Response of Metastatic Chromophobe Renal Cell Carcinoma to Vascular Endothelial Growth Factor (VEGF) Inhibitors: Should Increased VEGF-C Expression Be Used to Guide Treatment?

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