Brain Metastasis From Renal-Cell Carcinoma: An Institutional Study

Suarez‐Sarmiento, Alfredo; Nguyen, Kevin A.; Syed, Jamil; Nolte, Adam; Ghabili, Kamyar; Cheng, Michelle; Liu, Sandy; Chiang, Veronica; Kluger, Harriet M.; Hurwitz, Michael; Shuch, Brian

doi:10.1016/j.clgc.2019.08.006

Cited by 39 publications

(36 citation statements)

References 30 publications

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“…In RCC cases, some retrospective studies have shown possible benefits from central nervous system (CNS) screening to allow identification of smaller lesions that are more amenable to treatment. Those reports suggest that those with solitary BM are less likely to develop CNS recurrence after local therapy, and selected patients with good performance status might derive prolonged survival from aggressive therapy [ 16 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

Current Multimodality Treatments against Brain Metastases from Renal Cell Carcinoma

Matsui

2020

Cancers

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In patients with renal cell carcinoma, brain metastasis is generally one of the poor prognostic factors. However, the recent introduction of molecular target therapy and immune checkpoint inhibitor has remarkably advanced the systemic treatment of metastatic renal cell carcinoma and prolonged the patients’ survival. The pivotal clinical trials of those agents usually excluded patients with brain metastasis. The incidence of brain metastasis has been increasing in the actual clinical setting because of longer control of extra-cranial disease. Brain metastasis subgroup data from the prospective and retrospective series have been gradually accumulated about the risk classification of brain metastasis and the efficacy and safety of those new agents for brain metastasis. While the local treatment against brain metastasis includes neurosurgery, stereotactic radiosurgery, and conventional whole brain radiation therapy, the technology of stereotactic radiosurgery has been especially advanced, and the combination with systemic therapy such as molecular target therapy and immune checkpoint inhibitor is considered promising. This review summarizes recent progression of multimodality treatment of brain metastasis of renal cell carcinoma from literature data and explores the future direction of the treatment.

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Section: Resultsmentioning

confidence: 99%

Current Multimodality Treatments against Brain Metastases from Renal Cell Carcinoma

Matsui

2020

Cancers

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“…In a retrospective series focused on patients with metastatic RCC in the brain, Shuch et al suggested that clear cell RCC appeared to be the predominant histological type that metastasized to the brain, and this type accounted for 92.7% of RCC patients with BM [27]. Suarez-Sarmiento et al also found that clear cell RCC patients were [28]. Our study also identified histological type as an independent BM-related risk factor for RCC patients, which was similar to previous observations.…”

Section: Discussionmentioning

confidence: 99%

Construction and Validation of a Convenient Clinical Nomogram to Predict the Risk of Brain Metastasis in Renal Cell Carcinoma Patients

Tong

Huang

et al. 2020

BioMed Research International

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Brain metastasis (BM) is a typical type of metastasis in renal cell carcinoma (RCC) patients. The early detection of BM is likely a crucial step for RCC patients to receive appropriate treatment and prolong their overall survival. The aim of this study was to identify the independent predictors of BM and construct a nomogram to predict the risk of BM. Demographic and clinicopathological data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database for RCC patients between 2010 and 2015. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors, and then, a visual nomogram was constructed. Multiple parameters were used to evaluate the discrimination and clinical value. We finally included 42577 RCC patients. Multivariate logistic regression analysis showed that histological type, tumor size, bone metastatic status, and lung metastatic status were independent BM-associated risk factors for RCC. We developed a nomogram to predict the risk of BM in patients with RCC, which showed favorable calibration with a C -index of 0.924 (0.903-0.945) in the training cohort and 0.911 (0.871-0.952) in the validation cohort. The calibration curves and decision curve analysis (DCA) also demonstrated the reliability and accuracy of the clinical prediction model. The nomogram was shown to be a practical, precise, and personalized clinical tool for identifying the RCC patients with a high risk of BM, which not only will contribute to the more reasonable allocation of medical resources but will also enable a further improvements in the prognosis and quality of life of RCC patients.

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“…In this regard, the evidence of solitary and smaller BM in selected younger patients with a good performance status can lead to a prolonged survival from aggressive therapy, and decreased CNS recurrence risk. [ 5 , 30 ].…”

Section: Clinico-radiological Features Of Bmrcc and Indications For Brain Surveillance In Rcc Patientsmentioning

confidence: 99%

Prognostic Factors and Current Treatment Strategies for Renal Cell Carcinoma Metastatic to the Brain: An Overview

Internò

Santis

Stucci

et al. 2021

Cancers

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Renal cell carcinoma (RCC) is one of primary cancers that frequently metastasize to the brain. Brain metastasis derived from RCC has the propensity of intratumoral hemorrhage and relatively massive surrounding edema. Moreover, it confers a grim prognosis in a great percentage of cases with a median overall survical (mOS) around 10 months. The well-recognized prognostic factors for brain metastatic renal cell carcinoma (BMRCC) are Karnofsky Performance Status (KPS), the number of brain metastasis (BM), the presence of a sarcomatoid component and the presence of extracranial metastasis. Therapeutic strategies are multimodal and include surgical resection, radiotherapy, such as stereotactic radiosurgery due to the radioresistance of RCC and systemic strategies with tyrosin kinase inhibitors (TKI) or Immune checkpoint inhibitors (ICI) whose efficacy is not well-established in this setting of patients due to their exclusion from most clinical trials. To date, in case of positive prognostic factors and after performing local radical therapies, such as complete resection of BM or stereotactic radiosurgery (SRS), the outcome of these patients significantly improves, up to 33 months in some patients. As a consequence, tailored clinical trials designed for BMRCC are needed to define the correct treatment strategy even in this poor prognostic subgroup of patients.

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Brain Metastasis From Renal-Cell Carcinoma: An Institutional Study

Cited by 39 publications

References 30 publications

Current Multimodality Treatments against Brain Metastases from Renal Cell Carcinoma

Current Multimodality Treatments against Brain Metastases from Renal Cell Carcinoma

Construction and Validation of a Convenient Clinical Nomogram to Predict the Risk of Brain Metastasis in Renal Cell Carcinoma Patients

Prognostic Factors and Current Treatment Strategies for Renal Cell Carcinoma Metastatic to the Brain: An Overview

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