Survival Outcomes for Metastatic RCC and Sarcomatoid Dedifferentiation

Matthew T. Campbell, MD, assistant professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, discusses survival outcomes for patients with both metastatic renal cell carcinoma (RCC) and sarcomatoid dedifferentiation and how they each have evolved over the past few years.

According to Campbell, patients with clear cell RCC with sarcomatoid had a worse prognosis than patients diagnosed with clear cell alone. This was the same for patients with papillary sarcomatoid or those with sarcomatoid chromophobe.

In recent years, there has been a positive shift and a number of advances made for patients with RCC. Specifically, immunotherapy has shown to have benefits in this patient population.

Cambell also highlights the CheckMate-214 study (NCT02231749) of nivolumab (Opdivo) combined with ipilimumab (Yervoy) compared with sunitinib (Sutent) in patients with previously untreated advanced or metastatic renal cell carcinoma.

Transcription:

0:08 | These patients used to have the very worst prognosis of patients diagnosed with just about any histology. Clear cell with sarcomatoid did worse than the patients just with clear cell. Same with their counterparts with papillary sarcomatoid, [or] chromophobe sarcomatoid. They were, in a sense, more resistant to targeted therapy. However, we are seeing tremendous benefit with immunotherapy, and I would say that is the number 1 predictive biomarker of response to immune checkpoint therapy is the presence of sarcomatoid.

0:46 | My partner at MD Anderson Cancer Center has presented data on how patients with sarcomatoid are treated with nivolumab and ipilimumab from the CheckMate-214 study. It was a subgroup, but the patients did extremely well, and the response rate of approximately 60% complete response rate pushing 20% was quite impressive. We are seeing that those patients with sarcomatoid features who are living longer may not be reaching the same bar that the rest of the clear cell population but significantly improving.