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Cabozantinib in Pretreated Patients with Metastatic Renal Cell Carcinoma with Sarcomatoid Differentiation: A
Matteo Santoni1, Francesco Massari2, Enrique Grande3
1Oncology Unit, Macerata Hospital, Macerata, Italy. mattymo@alice.it.
Background:
Renal cell carcinoma with sarcomatoid differentiation is a highly aggressive form of kidney cancer.
Objective:
We aimed to analyze the outcomes of patients treated with cabozantinib for metastatic renal cell carcinoma with sarcomatoid features.
Methods:
We retrospectively collected data from 16 worldwide centers. Overall survival and progression-free survival were analyzed using Kaplan-Meier curves. Cox proportional models were used for univariate and multivariate analyses.
Results:
We collected data from 66 patients with metastatic sarcomatoid renal cell carcinoma receiving cabozantinib as second-line (51%) or third-line (49%) therapy. The median progression-free survival from the start of cabozantinib was 7.59 months (95% confidence interval [CI] 5.75-17.49) and was longer in male patients (8.81 vs 5.95 months, p = 0.042) and in patients without bone metastases (7.59 vs 5.11 months, p = 0.010); the median overall survival was 9.11 months (95% CI 7.13-23.80). At the multivariate analysis, female sex (hazard ratio = 1.81; 95% CI 1.02-3.37, p = 0.046), bone metastases (hazard ratio = 2.62; 95% CI 1.34-5.10, p = 0.005), and International Metastatic Renal Cell Carcinoma Database Consortium criteria (hazard ratio = 3.04; 95% CI 1.54-5.99, p = 0.001) were significant predictors of worse overall survival.
Conclusions:
Our data show that cabozantinib is active in pretreated patients with sarcomatoid renal cell carcinoma. Biomarkers are needed in this field to select patients for multi-kinase inhibitors or other options.
Insights
Cabozantinib shows activity in patients with metastatic sarcomatoid renal cell carcinoma. Further research is needed to identify biomarkers for selecting patients for targeted therapies.
Area of Science:
- Oncology
- Medical Research
Background:
- Renal cell carcinoma (RCC) with sarcomatoid differentiation is an aggressive cancer.
- Metastatic RCC (mRCC) with sarcomatoid features presents unique treatment challenges.
Purpose of the Study:
- To evaluate the efficacy of cabozantinib in patients with metastatic sarcomatoid RCC.
- To identify prognostic factors influencing outcomes in this patient population.
Main Methods:
- Retrospective analysis of data from 16 international centers.
- Inclusion of 66 patients with metastatic sarcomatoid RCC treated with cabozantinib.
- Survival outcomes (overall survival and progression-free survival) analyzed using Kaplan-Meier curves and Cox proportional models.
Main Results:
- Median progression-free survival was 7.59 months; median overall survival was 9.11 months.
- Progression-free survival was longer in male patients and those without bone metastases.
- Female sex, bone metastases, and IMDC criteria were significant predictors of worse overall survival.
Conclusions:
- Cabozantinib demonstrates activity in pretreated patients with sarcomatoid RCC.
- Development of biomarkers is crucial for optimizing treatment selection for multi-kinase inhibitors in this aggressive cancer subtype.
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