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Updated: May 10, 2026
A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
First experience of active surveillance before systemic target therapy in patients with metastatic renal cell
Nobuaki Matsubara1, Hirofumi Mukai, Yoichi Naito
1Division of Oncology and Hematology, National Cancer Center Hospital East, Chiba, Japan. nmatsuba@east.ncc.go.jp
Objective:
To reveal the outcomes of initial active surveillance (AS), followed by deferred systemic target therapy, in a subpopulation of patients with indolent metastatic renal cell carcinoma (mRCC).
Methods:
We retrospectively reviewed the clinical and pathologic data of patients with mRCC, who initially were monitored by planned AS before systemic therapy because of their preference and asymptomatic or slowly progressive disease, at our institution between 2000 and 2011. The primary outcome measures were progression-free survival (PFS) and overall survival (OS).
Results:
Twenty-nine patients with a metastatic lesion at start of AS were eligible for this analysis. The median age at the start of AS was 69 years. Of these patients, 65% had recurrent disease and 35% were in stage IV. All patients had undergone nephrectomy and 86% had clear-cell carcinoma. No patients were categorized into a poor risk according to Memorial Sloan-Kettering Cancer Center (MSKCC) and Heng criteria. The median follow-up period was 35.4 months. Disease progression was observed in 72% of patients, but only 14% died during the follow-up period. The median PFS time was 26.1 months. After disease progression was observed, only 58% of these patients received treatment. The median OS had not been reached, but 12, 24, and 48 months OS rates were 96.4%, 88.7%, and 83.8%, respectively.
Conclusion:
PFS and OS of patients who underwent AS were acceptable. AS might be a reasonable approach, particularly for patients with prolonged, indolent course of the disease. Further observational studies with a larger sample size might be needed.
Insights
Active surveillance (AS) followed by systemic therapy is a viable option for indolent metastatic renal cell carcinoma (mRCC). This approach showed acceptable progression-free survival (PFS) and overall survival (OS) in patients with slow-progressing disease.
Area of Science:
- Oncology
- Urology
- Medical Research
Background:
- Metastatic renal cell carcinoma (mRCC) management can be challenging.
- Indolent mRCC subtypes may benefit from tailored surveillance strategies.
Purpose of the Study:
- To evaluate the outcomes of active surveillance (AS) followed by delayed systemic therapy in patients with indolent mRCC.
- To assess progression-free survival (PFS) and overall survival (OS) in this specific patient group.
Main Methods:
- Retrospective review of clinical and pathological data of mRCC patients.
- Inclusion criteria: initial AS, preference for monitoring, asymptomatic or slowly progressive disease.
- Primary outcome measures: PFS and OS.
Main Results:
- 29 patients with metastatic lesions at AS start were analyzed.
- Median follow-up: 35.4 months. Median PFS: 26.1 months.
- High 12, 24, and 48-month OS rates (96.4%, 88.7%, 83.8%).
Conclusions:
- Active surveillance (AS) demonstrated acceptable PFS and OS for indolent mRCC.
- AS may be a suitable strategy for patients with a slow disease course.
- Further large-scale observational studies are warranted.
