202MO - Real-world outcomes of non-clear cell renal cell carcinoma: Retrospective study from tertiary cancer center in India

Background

Non-clear cell renal cell carcinoma (nccRCC) represents a heterogenous group of RCC with limited representation in clinical trials due to their rarity and diverse histopathology. Thus, real-world data becomes important to give clue to the treating physicians for selecting the best possible treatment.

Methods

This is a retrospective, single center study to evaluate the outcomes of patients with nccRCC diagnosed and treated at Tata Memorial Center, Mumbai between 2017 and 2019. Baseline clinical features, histologic subtypes, therapeutic management and survival status were analyzed. SPPS version 20 was used for all statistical analyses.

Results

A total of 159 consecutive patients of nccRCC were evaluated for this study, 20 patients were excluded as these patients defaulted after their first visit. Out of 139 evaluable patients, 71.2% were males, the median age at diagnosis was 57 years (range: 10-81). Histologic subtypes comprised 76.2% papillary carcinoma, 6.5% sarcomatoid, 7.9% chromophobe, 1.4% unclassified tumors, and 0.7% oncocytoma. 51 (32%) patients were metastatic at presentation; 3 received supportive care alone due to poor performance status, 39.2% received sorafenib, sunitinib 27.4%, pazopanib 21.6% while bevacizumab erlotinib was given to 5.9% patients as first-line therapy. The median PFS of the overall patients was 6 months (95% CI: 2.4–9.6). The best response was partial response in 16.6%, stable disease 37.5%, and progressive disease in 45.8% of the patients. Only 21 (43.8%) could receive second-line therapy with everolimus being the most commonly used (38%). At the time of the data cut-off point (July 1, 2020), 29 metastatic patients had died, with a median overall survival of 11.9 months (95% CI: 5.4–18.4) with a median follow up of 14 months.

Conclusions

Papillary RCC comprised of the majority of the patients with nccRCC. This study reports worse survival outcomes as compared to other published studies. This might arise due to less use of subsequent lines of therapy and extremely low use of immunotherapy in the real-world scenario. Overall, the prognosis of nccRCC remains poor with a significant room for improvement.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.