An Unusual Metastatic Renal Cell Carcinoma with Maintained Complete Response to Sunitinib Treatment

Chara, L.E.; Rodriguez, Beatriz Walter; Holgado, Esther; Ramírez, Natalia; Fernández-Rañada, Isabel; Mohedano, Nicolás Mohedano; Arcediano, Alberto; García, Inés Cañas; Cassinello, Javier

doi:10.1159/000335016

Cited by 10 publications

(8 citation statements)

References 7 publications

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“…We were surprised by the very long PFS (27.7 months) and OS (38.4 months) that we recorded in the prospective clinical trials as compared with those described in the pivotal trial that lead to sunitinib approval (PFS=11 months; OS=20.5 months) ( Motzer et al , 2007 ; Motzer et al , 2009 ). However, some patients respond for a long period of time to sunitinib reaching 4–5 years ( Chara et al , 2011 ). Therefore, the long PFS and OS probably reflect the recruitment by serendipity of good responders.…”

Section: Discussionmentioning

confidence: 99%

CXCL7 is a predictive marker of sunitinib efficacy in clear cell renal cell carcinomas

Dufies¹,

Giuliano²,

Viotti³

et al. 2017

Br J Cancer

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Background:Sunitinib is one of the first-line standard treatments for metastatic clear cell renal cell carcinoma (ccRCC) with a median time to progression shorter than 1 year. The objective is to discover predictive markers of response to adapt the treatment at diagnosis.Methods:Prospective phase 2 multi-centre trials were conducted in ccRCC patients initiating sunitinib (54 patients) or bevacizumab (45 patients) in the first-line metastatic setting (SUVEGIL and TORAVA trials). The plasmatic level of CXCL7 at baseline was correlated with progression-free survival (PFS).Results:The cut-off value of CXCL7 for PFS was 250 ng ml−1. Patients with CXCL7 plasmatic levels above the cut-off at baseline (250 ng ml−1) had a significantly longer PFS (hazard ratio 0.323 (95% confidence interval 0.147–0.707), P=0.001). These results were confirmed in a retrospective validation cohort. The levels of CXCL7 did not influence PFS of the bevacizumab-treated patients.Conclusions:CXCL7 may be considered as a predictive marker of sunitinib efficacy for ccRCC patients.

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Section: Discussionmentioning

confidence: 99%

CXCL7 is a predictive marker of sunitinib efficacy in clear cell renal cell carcinomas

Dufies¹,

Giuliano²,

Viotti³

et al. 2017

Br J Cancer

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“…Some authors suggest metastasectomy in cases with unifocal metastatic renal cell carcinoma since these patients have a favorable overall survival rate in comparison to patients with metastatic disease to the pancreas originating from other primary sites [18]. Systemic chemotherapy with sunitinib has also been shown to be an efficacious management option for metastatic renal cell carcinoma [19]. The use of radiotherapy should be reserved for high-risk patients [3].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Renal Cell Carcinoma to the Pancreas: Diagnostic Significance of Fine-Needle Aspiration Cytology

Gilani¹,

Tashjian²,

Danforth³

et al. 2013

Acta Cytologica

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Background: Renal cell carcinoma rarely metastasizes to the pancreas. Diagnosing a neoplasm that is metastatic to the pancreas by fine-needle aspiration (FNA) cytology is often challenging. A detailed clinical history may prove to be beneficial. Case Reports: A total of 729 pancreatic FNAs were performed from January 2005 through August 2012 at our institution. Among these, we found 3 patients with a prior history of a malignant renal neoplasm who presented with a pancreatic mass: 2 in the tail and 1 in the head. Radiographically, they ranged in size from 2.5 to 7.0 cm. Microscopic evaluation of cytologic material obtained during endoscopic ultrasound-guided FNA (EUS-FNA) revealed cohesive clusters of atypical cells with clear cytoplasm and prominent nucleoli surrounded by a thin capillary network. The neoplastic cells were immunoreactive with CD10 (cases 2 and 3). A diagnosis of metastatic clear cell renal cell carcinoma was rendered for each case based on the morphologic features and immunohistochemical staining pattern of the neoplastic cells. Histologic comparison with the available slides of the corresponding primary renal neoplasm confirmed the diagnosis. Conclusion: We conclude that EUS-FNA of pancreatic masses is an important, effective, and accurate diagnostic modality for early diagnosis of both primary and metastatic neoplasms of the pancreas.

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“…Targeted therapies with multi-tyrosine kinase inhibitors, MTOR inhibitors, VEGF inhibitors and immunotherapies proved to be highly effective in mRCC (238)(239)(240)(241)(242)(243). The improvement also concerned the results of medical treatment of the few isPM patients reported so far (163,178,190,(244)(245)(246)(247). Future prospective studies will have to show the significance of surgical or drug therapy, or combinations of both, for respectable isPM (166,182,186,191).…”

Section: Treatment Resultsmentioning

confidence: 99%

Isolated Pancreatic Metastases of Renal Cell Carcinoma—A Paradigm of a Seed and Soil Mechanism: A Literature Analysis of 1,034 Observations

Sellner

2020

Front. Oncol.

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Previously documented arguments, in favor of the suspected impact of a seed and soil mechanism, in the development and progression of isolated pancreatic metastasis of renal cell carcinomas (isPM) are: (1) uniform and independent from the side of the primary tumor distribution of isPM within the pancreas and, (2) the similar survival rates for singular and multiple isPM. In addition, the present study adds new arguments that further confirm the importance of an seed and soil mechanism in isPM: (1) Within the singular isPM, the size of the metastasis does not affect the overall survival; (2) Within the group of multiple isPMs, the overall survival does not depend on the number of metastases; (3) For synchronous and metachronous isPM, survival rates are also not different, and (4) Within the group of metachronous isPM there is also no correlation between the overall survival and interval until metastases occurs. This unusual ineffectiveness of otherwise known risk factors of solid cancers can be explained plausibly by the hypothesis of a very selective seed and soil mechanism in isPM. It only allows embolized renal carcinoma cells in the pancreas to complete all steps required to grow into clinically manifest metastases. In all other organs, on the other hand, the body is able to eliminate the embolized tumor cells or at least put them into a dormant state for many years. This minimizes the risk of occult micrometastases in distant organs, which could later-after isPM treatment-grow into clinically manifest metastases, so that the prognosis of the isPM is only determined by an adequate therapy of the pancreatic foci, and prognostic factors, such as total tumor burden or interval until the occurrence of the isPM remain ineffective.

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An Unusual Metastatic Renal Cell Carcinoma with Maintained Complete Response to Sunitinib Treatment

Cited by 10 publications

References 7 publications

CXCL7 is a predictive marker of sunitinib efficacy in clear cell renal cell carcinomas

CXCL7 is a predictive marker of sunitinib efficacy in clear cell renal cell carcinomas

Metastatic Renal Cell Carcinoma to the Pancreas: Diagnostic Significance of Fine-Needle Aspiration Cytology

Isolated Pancreatic Metastases of Renal Cell Carcinoma—A Paradigm of a Seed and Soil Mechanism: A Literature Analysis of 1,034 Observations

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