Benoit Beuselinck1, Evelyne Lerut2, Pascal Wolter3, Herlinde Dumez3, Johannes Berkers4, Hendrik Van Poppel4, Steven Joniau4, Raymond Oyen5, Liesbeth De Wever5, Michiel Strijbos3, Robert Paridaens3, Patrick Schöffski3. 1. General Medical Oncology and Laboratory for Experimental Oncology, University Hospitals Leuven, Leuven Cancer Institute, KU Leuven. Electronic address: benoit.beuselinck@uzleuven.be. 2. Pathology, University Hospitals Leuven, Department of Imaging and Pathology, KU Leuven. 3. General Medical Oncology and Laboratory for Experimental Oncology, University Hospitals Leuven, Leuven Cancer Institute, KU Leuven. 4. Urology, University Hospitals Leuven, KU Leuven. 5. Radiology, University Hospitals Leuven, Department of Imaging and Pathology, KU Leuven.
Abstract
INTRODUCTION: This study aimed to assess the efficacy of anti-vascular endothelial growth factor receptor tyrosine kinase inhibitors (anti-VEGFR-TKIs) in patients with metastatic clear cell renal cell carcinoma (m-ccRCC) with sarcomatoid dedifferentiation. PATIENTS AND METHODS: The files of all patients with m-ccRCC consecutively treated with first-line anti-VEGFR-TKIs at the authors' institution were retrospectively reviewed. Pathology slides from nephrectomy and metastasectomy were assessed for the presence and extent of sarcomatoid dedifferentiation. RESULTS: A total of 124 patients were included; nephrectomy and metastasectomy specimens were available in 117 and 35 patients, respectively. Thirty percent of the primary nephrectomy specimens had sarcomatoid features, and the median involvement of the sarcomatoid component was 21% (range, 1%-95%). Patients with an important sarcomatoid component, defined as ≥ 25% involvement of the tumor, had a very poor outcome: progression-free survival (PFS) and overall survival (OS) were 3 and 6 months, respectively, and no partial responses (PR) were observed. Patients without sarcomatoid dedifferentiation or with sarcomatoid involvement < 25% had a PFS of 12 months (P < .0001; hazard ratio [HR], 51; 95% CI, 12.58-207.3), an OS of 22 months (P < .0001, HR, 10.72; 95% CI, 3.56-32.25), and a PR rate of 50% (P = .0015). Patients with a sarcomatoid component ≥ 25% in the metastasectomy also had a poorer PFS and OS on anti-VEGFR-TKIs compared with patients with < 25% of sarcomatoid features at these sites. CONCLUSION: Patients with m-ccRCC whose tumors contain a component of sarcomatoid dedifferentiation of ≥ 25% of the total tumor volume have a very poor outcome when treated with anti-VEGFR-TKIs. Analysis of the extent of sarcomatoid features in resected metastases can provide additional prognostic information.
INTRODUCTION: This study aimed to assess the efficacy of anti-vascular endothelial growth factor receptor tyrosine kinase inhibitors (anti-VEGFR-TKIs) in patients with metastatic clear cell renal cell carcinoma (m-ccRCC) with sarcomatoid dedifferentiation. PATIENTS AND METHODS: The files of all patients with m-ccRCC consecutively treated with first-line anti-VEGFR-TKIs at the authors' institution were retrospectively reviewed. Pathology slides from nephrectomy and metastasectomy were assessed for the presence and extent of sarcomatoid dedifferentiation. RESULTS: A total of 124 patients were included; nephrectomy and metastasectomy specimens were available in 117 and 35 patients, respectively. Thirty percent of the primary nephrectomy specimens had sarcomatoid features, and the median involvement of the sarcomatoid component was 21% (range, 1%-95%). Patients with an important sarcomatoid component, defined as ≥ 25% involvement of the tumor, had a very poor outcome: progression-free survival (PFS) and overall survival (OS) were 3 and 6 months, respectively, and no partial responses (PR) were observed. Patients without sarcomatoid dedifferentiation or with sarcomatoid involvement < 25% had a PFS of 12 months (P < .0001; hazard ratio [HR], 51; 95% CI, 12.58-207.3), an OS of 22 months (P < .0001, HR, 10.72; 95% CI, 3.56-32.25), and a PR rate of 50% (P = .0015). Patients with a sarcomatoid component ≥ 25% in the metastasectomy also had a poorer PFS and OS on anti-VEGFR-TKIs compared with patients with < 25% of sarcomatoid features at these sites. CONCLUSION:Patients with m-ccRCC whose tumors contain a component of sarcomatoid dedifferentiation of ≥ 25% of the total tumor volume have a very poor outcome when treated with anti-VEGFR-TKIs. Analysis of the extent of sarcomatoid features in resected metastases can provide additional prognostic information.
Authors: Mehrad Adibi; Arun Z Thomas; Leonardo D Borregales; Megan M Merrill; Rebecca S Slack; Hsiang-Chun Chen; Kanishka Sircar; Paari Murugan; Pheroze Tamboli; Eric Jonasch; Nizar M Tannir; Surena F Matin; Christopher G Wood; Jose A Karam Journal: Urol Oncol Date: 2015-05-23 Impact factor: 3.498
Authors: Fumi Kawakami; Kanishka Sircar; Jaime Rodriguez-Canales; Bryan M Fellman; Diana L Urbauer; Pheroze Tamboli; Nizar M Tannir; Eric Jonasch; Ignacio I Wistuba; Christopher G Wood; Jose A Karam Journal: Cancer Date: 2017-08-22 Impact factor: 6.860
Authors: Abhishek Maiti; Maryam Nemati-Shafaee; Pavlos Msaouel; Lance C Pagliaro; Eric Jonasch; Nizar M Tannir; Amishi Y Shah Journal: Clin Genitourin Cancer Date: 2017-08-10 Impact factor: 2.872
Authors: Renata Colombo Bonadioa; Pedro Isaacsson Velho; Guilherme Nader Marta; Mirella Nardo; Manoel Carlos LA Souza; David Qb Muniz; Regis Of Bezerra; Raisa Ka Bispo; Sheila F Faraj; Diogo A Bastos; Carlos Dzik Journal: Ecancermedicalscience Date: 2019-11-04
Authors: B Beuselinck; J Jean-Baptiste; G Couchy; S Job; A De Reynies; P Wolter; C Théodore; G Gravis; B Rousseau; L Albiges; S Joniau; V Verkarre; E Lerut; J J Patard; P Schöffski; A Méjean; R Elaidi; S Oudard; J Zucman-Rossi Journal: Br J Cancer Date: 2015-10-13 Impact factor: 7.640