Molecular subtypes of clear-cell renal cell carcinoma (ccRCC) were prognostic for outcomes after metastasectomy, with significant differences seen in overall survival (OS) and disease-free survival (DFS) between groupings, according to findings presented at the 2017 European Multidisciplinary Meeting on Urological Cancers (EMUC).1
“Patients with subtypes 2 and 3 who are treated with sunitinib or pazopanib [Votrient] usually respond well to therapy,” Verbiest said in an interview with OncologyLive®. “Because comorbidity is associated with surgery, it might be best to avoid it, especially in these patients.”
Differences in Categories
The study presented at EMUC involved 32 patients: 22 with ccRCC subtypes 2 and 3 and 10 with ccRCC subtypes 1 and 4. Study objectives included correlating the molecular subtype with DFS, time to systemic therapy, and OS after complete metastasectomy. The researchers selected patients who had undergone a first metastasectomy with curative intent without prior systemic treatment. Other inclusion criteria included the availability of fresh frozen primary tumor tissue for genomic analysis, and having had at least 1 follow-up CT scan after metastasectomy.
Table. RCC Outcomes by Molecular Subtype1
The median OS in the ccRCC 2 and 3 groups was 133 months (5-year OS rate, 85%) compared with a median OS of 50 months (5-year OS rate, 19%) for the ccRCC 1 and 4 groups. This represented a significant reduction in the risk of death for those in the good-prognosis arm (HR, 5.47; P
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