Abstract 735P
Background
Collecting duct carcinoma (CDC) and renal medullary carcinoma (RMC) are two rare but aggressive subtypes of kidney cancers with a poor prognosis at metastatic setting. The first-line treatment is based on platinum salts and gemcitabine (GC) chemotherapy (CT) but there is no standard of care for subsequent lines. Few data are available on efficacy of systemic treatments after GC. The aim of our study was to assess the efficacy of treatments after first-line CT.
Methods
We performed a retrospective study of metastatic (m) CDC/RMC patients (pts) treated between 2010 and 2019 in 10 French centres. Data were collected from medical records. Pts included in clinical trials were accepted, including those treated with GC + bevacizumab (bev) in GETUG/AFU24 trial.
Results
Fifty one pts were included (n=32 CDC, n=19 RMC). Medium age was 51 y.o. 61% (n=31) were metastatic at diagnosis. At the time of analysis, 82% (n=42) pts were dead. After a median follow-up of 52 months (mo), the median overall survival was 11.9 mo (10.6-17.5). All patients received platinum salt based regimen +/- bev as first-line therapy. The median TTP was 6.5 mo and the objective response rate (ORR) 39%. The median number of treatment lines was 2 (1-5) but 39% pts received ≥ 3 lines. Subsequent treatments included: TKI (cabozantinib n=8; sunitinib n=1; pazopanib n=1), CT (taxane n=13; platinum salt n=10; anthracycline n=3; other n=4), ICI (nivolumab n=16; nivolumab + ipilimumab n=2). ORR range from 10 to 15% and the disease control rate (DCR) of 30 to 55% (Table). All partial responses with CT as subsequent-line were reported with GC +/- bev, including 2 rechallenge. Of note, 9 patients with CDC were still alive > 2 years after metastatic diagnosis. Table: 735P
| Type of treatment | ORR | DCR | Duration treatment (month) |
| Platinum salt regimen +/- bev (1 st line) (n=51) Missing data: n=5 | 18/46 (39%) | 34/46 (74%) | 3.4 |
| TKI (subsequent line) (n=11) Missing data: n=3 | 1/9 (11%) | 5/9 (55%) | 2.7 |
| IO (subsequent line) (n=19) | 2/19 (10%) | 6/19 (31.5%) | 2.3 |
| CT (n=30) Missing data: n=3 | 4/27 (15%) | 8/27 (30%) | 1.7 |
Conclusions
In our cohort, subsequent treatments after first-line GC showed very low antitumor activity in mCDC/RMC. A better understanding of the biology of those rare tumors is urgent to identify potential targets.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
APHP.
Funding
Has not received any funding.
Disclosure
E. Colomba-Blameble: Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Ipsen; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: BMS BMS ; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Pfizer; Honoraria (self), Advisory/Consultancy: Sanofi; Honoraria (self), Advisory/Consultancy: GSK; Travel/Accommodation/Expenses: Novartis. P. Barthélémy: Advisory/Consultancy, Travel/Accommodation/Expenses: BMS; Advisory/Consultancy, Travel/Accommodation/Expenses: Pfizer; Advisory/Consultancy, Travel/Accommodation/Expenses: Janssen; Advisory/Consultancy, Travel/Accommodation/Expenses: Sanofi; Advisory/Consultancy, Travel/Accommodation/Expenses: Ipsen; Advisory/Consultancy, Travel/Accommodation/Expenses: MSD; Advisory/Consultancy, Travel/Accommodation/Expenses: Roche; Advisory/Consultancy: EusaPharma; Advisory/Consultancy: Novartis; Advisory/Consultancy, Travel/Accommodation/Expenses: Astellas. C. Saldana: Honoraria (self): Sanofi; Honoraria (self): BMS; Advisory/Consultancy, Travel/Accommodation/Expenses: Pfizer; Advisory/Consultancy, Travel/Accommodation/Expenses: Ipsen; Travel/Accommodation/Expenses: Astellas. C. Dumont: Travel/Accommodation/Expenses: Ipsen. B. Laguerre: Honoraria (self): Roche; Honoraria (self): MSD; Honoraria (self): AstraZeneca; Travel/Accommodation/Expenses: Pfizer. D. Maillet: Honoraria (institution), Advisory/Consultancy, Travel/Accommodation/Expenses: Janssen; Advisory/Consultancy, Travel/Accommodation/Expenses: BMS; Advisory/Consultancy, Travel/Accommodation/Expenses: Pfizer; Advisory/Consultancy, Travel/Accommodation/Expenses: AstraZeneca; Advisory/Consultancy, Travel/Accommodation/Expenses: Sanofi; Advisory/Consultancy, Travel/Accommodation/Expenses: IPSEN; Advisory/Consultancy, Travel/Accommodation/Expenses: Novartis; Advisory/Consultancy, Travel/Accommodation/Expenses: MSD. C. Vicier: Travel/Accommodation/Expenses: Astellas; Travel/Accommodation/Expenses: Pfizer; Travel/Accommodation/Expenses: Roche; Research grant/Funding (institution): BMS. D. Borchiellini: Advisory/Consultancy, Research grant/Funding (institution): Astellas; Advisory/Consultancy, Research grant/Funding (institution): AstraZeneca; Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: BMS; Advisory/Consultancy: Ipsen; Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Janssen; Advisory/Consultancy, Research grant/Funding (institution): MSD; Advisory/Consultancy, Research grant/Funding (institution): Novartis; Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Pfizer; Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche; Advisory/Consultancy, Research grant/Funding (institution): Sanofi; Research grant/Funding (institution): Calithera; Research grant/Funding (institution): Exelixis; Research grant/Funding (institution): Infinity; Research grant/Funding (institution): Merck; Research grant/Funding (institution): KGaA. L. Albiges: Advisory/Consultancy: Pfizer; Advisory/Consultancy: Novartis; Advisory/Consultancy: Bristol Myer Squibb; Advisory/Consultancy: Ipsen; Advisory/Consultancy: Roche; Advisory/Consultancy: MSD; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Merck; Advisory/Consultancy: Amgen; Advisory/Consultancy: Astellas; Advisory/Consultancy: Exelixis; Advisory/Consultancy: Corvus Pharmaceuticals; Advisory/Consultancy: Peloton therapeutics. E. Auclin: Travel/Accommodation/Expenses: Mundipharma; Advisory/Consultancy: Sanofi. S. Oudard: Advisory/Consultancy, Travel/Accommodation/Expenses: Pfizer; Advisory/Consultancy, Travel/Accommodation/Expenses: Bayer; Advisory/Consultancy, Travel/Accommodation/Expenses: Novartis; Advisory/Consultancy, Travel/Accommodation/Expenses: BMS; Advisory/Consultancy, Travel/Accommodation/Expenses: Merck; Advisory/Consultancy, Travel/Accommodation/Expenses: Janssen; Advisory/Consultancy, Travel/Accommodation/Expenses: Astellas; Travel/Accommodation/Expenses: Sanofi. C. Thibault: Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Pfizer; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Advisory/Consultancy: Sanofi; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Janssen; Honoraria (self), Advisory/Consultancy: Astellas; Honoraria (self): Ipsen. All other authors have declared no conflicts of interest.