213P - An observational retrospective real-world study of sarcomatoid renal cell carcinoma (sRCC) patients in an Asian cancer centre

Background

Renal cell carcinoma with sarcomatoid de-differentiation (sRCC) is a highly aggressive form RCC with trials reporting a poor median OS of 5 to 12 months. Recent genomics profiling of sRCC suggest that Srcc is not a single entity but is highly influenced by the parent RCC subtype from which its shares histological characteristic. A recent meta-analysis suggests that sRCC is associated with a higher cancer specific mortality, poorer progression free and overall survival but not gender and average age. A population-based study of 879 patients taken from the SEER data showed that the 5-year DSS were 77.7%, 67.8%, 35.4%, and 3.5% for patients with stage I, II, III, and IV disease at diagnosis.

Methods

A retrospective analysis was conducted on patients diagnosed with sRCC from 1997 to 2018. Disease characteristics, treatment outcomes and adverse events were retrieved from digital medical records. Overall survival and progression free survival were estimated using Kaplan Meier method.

Results

62 patients with a diagnosis of sRCC were identified. 72% (n = 45) were males. Median age was 56 years old on diagnosis. Majority of patients were Chinese at 72%. 52%(N = 32) were metastatic on diagnosis with 18%(n = 12) were diagnosed with initially early stages(I-II). 80%(n = 47) were symptomatic from the cancer on diagnosis with at least 1 symptom of haematuria, flank pain, fever, loss of weight. Majority of the patients (n = 54) had were clear cell rcc with sarcomatoid component while the 7% (n = 5) were papillary rcc. The median overall survival for the metastatic group was 1.26 years with 53% having had VEGF inhibitors as first line treatment while about a quarter had no treatment.

Conclusions

We currently report the disease characteristics and treatment of patients diagnosed with sRCC in our tertiary cancer centre. In our study, about half of the cohort was metastatic on diagnosis with another 20% having early stage on initial diagnosis. The overall survival outcomes of this real world metastatic sRCC group is promising and appears better than prior reports. More research is needed to better understand this group of patients with poor outcomes.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Ravindran Kanesvaran.

Funding

Has not received any funding.

Disclosure

R. Kanesvaran: Advisory / Consultancy: MSD; Advisory / Consultancy: BMS; Honoraria (self), Advisory / Consultancy: Ipsen; Honoraria (self), Advisory / Consultancy: Eisai; Honoraria (self), Advisory / Consultancy: Astellas; Honoraria (self), Advisory / Consultancy: Johnson and Johnson. All other authors have declared no conflicts of interest.