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P155

Patients (pts) with metastatic chromophobe renal cell carcinoma (mchRCC) treated with sunitinib (Su) therapy (tx): Analysis of an international database regarding outcome and comparison to clear cell histology (mccRCC)

By: Keizman D.1, Sarid D.2, Lee J.3, Chish A.1, Sella A.4, Gottfried M.1, Hammers H.5, Eisenberger M.5, Carducci M.5, Sinibaldi V.5, Neiman V.6, Rosenbaum E.6, Gez E.2, Peer A.7, Neumann A.7, Kovel S.4, Mermershtain W.8, Rouvinov K.8, Berger R.9
Institutes: 1Meir Medical Center, Dept. of Oncology, Kefar-Saba, 2Tel-Aviv Medical Center, Dept. of Oncology, Tel-Aviv, 3Asan Medical Center, Dept. of Oncology, Seoul, 4Assaf Harofeh Medical Center, Dept. of Oncology, Zerifin, 5Johns Hopkins Medical Center, Dept. of Oncology, Baltimore, 6Rabin Medical Center, Dept. of Oncology, Petah-Tikva, 7Rambam Medical Center, Dept. of Oncology, Haifa, 8Soroka Medical Center, Dept. of Oncology, Beer Sheba, 9Sheba Medical Center, Dept. of Oncology, Tel-Hashomer

Introduction & Objectives

Su is a standard tx for mccRCC. Data on its activity in the rare variant of mchRCC, is limited by very small or heterogeneous (mixed histology with papillary type, or mixed targeted therapies) studies. We analysed the activity of Su in a relatively large and homogenous international cohort of mchRCC pts, in terms of outcome and comparison to mccRCC.

Material & Methods

Records from mchRCC pts treated with 1st line Su in 9 centers across 4 countries were retrospectively reviewed. Univariate and multivariate analyses of association between clinicopathologic factors and outcome were performed. Subsequently, mchRCC pts were individually matched to mccRCC pts. We compared the response rate (RR), progression free survival (PFS), and overall survival (OS) between the groups.

Results

Between 2004-2014, 33 pts (median age 64, 45% male) with mchRCC were treated with Su as 1st line tx. 76% had a prior nephrectomy. HENG risk was good 27%, intermediate 55%, and poor 18%. 33% were active smokers, and 30% users of angiotensin system inhibitors (ASIs). 55%, 27%, and 33% had lung, liver and bone metastases, respectively. 48% had a pre-tx neutrophil to lymphocyte ratio (NLR) >3. 42% had dose reduction/tx interruption (DR/TI). Su induced hypertension (HTN) occurred in 48%. 75% achieved a clinical benefit (partial response + stable disease), while 25% had disease progression within the first 3 months of tx. Median PFS and OS were 10 and 26 months, respectively. Factors associated with PFS were the HENG risk (HR 3.8, p=0.025) and pre-tx NLR >3 (HR 0.6, p=0.012). Factors associated with OS were the HENG risk (HR 4.27, p=0.027), liver metastases (HR 4.6, p=0.029), and pre-treatment NLR < 3 (HR 0.5, p=0.04). Tx outcome was not significantly different between mchRCC pts and mccRCC pts, who were individually matched by HENG risk, nephrectomy/smoking status, pre-tx NLR, use of ASIs, DR/TI, and Su induced HTN. In mccRCC pts (p value versus mchRCC), 70% achieved a clinical benefit (p=0.58), and median PFS and OS were  9 (p=0.7) and 24 (p=0.6) months, respectively.

Conclusions

In mchRCC pts, Su tx may have similar outcome to mccRCC pts.

  • Type: Abstract
  • Date: 12-11-2015
  • Rating: 0,0
  • Views: 745
  • Event: 7th European Multidisciplinary Meeting on Urological Cancers
  • Nr: P155
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