A critical appraisal of systemic treatment options for metastatic non-clear cell renal cell carcinoma

Salima Ismail; Malek Meskawi; Jens Hansen; Marco Bianchi; Zhe Tian; Mathieu Latour; Markus Graefen; Francesco Montorsi; Quoc-Dien Trinh; Paul Perrotte; Pierre I Karakiewicz; Maxine Sun

doi:10.1016/j.critrevonc.2013.12.003

A critical appraisal of systemic treatment options for metastatic non-clear cell renal cell carcinoma

Crit Rev Oncol Hematol. 2014 Apr;90(1):49-57. doi: 10.1016/j.critrevonc.2013.12.003. Epub 2013 Dec 12.

Authors

Affiliations

¹ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Department of Urology, University of Montreal Health Center, Montreal, Canada. Electronic address: [email protected].
² Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada.
³ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Martini-Klinic, Prostate Cancer Center Eppendorf-Hamburg, Hamburg, Germany.
⁴ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Department of Urology, Urological Research Institute, Vita-Salute San Raffaele University, Milan, Italy.
⁵ Department of Pathology, University of Montreal, Montreal, Canada.
⁶ Martini-Klinic, Prostate Cancer Center Eppendorf-Hamburg, Hamburg, Germany.
⁷ Department of Urology, Urological Research Institute, Vita-Salute San Raffaele University, Milan, Italy.
⁸ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA.
⁹ Department of Urology, University of Montreal Health Center, Montreal, Canada.
¹⁰ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Department of Urology, University of Montreal Health Center, Montreal, Canada.

PMID: 24411587
DOI: 10.1016/j.critrevonc.2013.12.003

Abstract

Current guidelines provide most support for the use of temsirolimus in first line therapy for metastatic non-clear cell renal cell carcinoma (nccRCC). However, this recommendation is based on scant level 2a evidence. The objective of this review is to examine the evidence supporting first line temsirolimus use in patients with metastatic nccRCC as well as alternative first line treatment options. Six studies, that assessed the efficacy of five agents qualified for inclusion. Among recognized treatment options for metastatic nccRCC, mean weighted progression free survival values of 7.9 months for temsirolimus vs. 7.3 for sunitinib vs. 8.5 months for sorafenib vs. ≈4.1 months for erlotinib were recorded based on data from 10, 74, 33 and 51 patients respectively. In conclusion, the data supporting first line temsirolimus for metastatic nccRCC are based on a small patient sample. Sunitinib's efficacy is similar to that of temsirolimus but is based on a bigger patient sample that originates from phase II studies.

Keywords: Chromophobe; Metastatic; Non-clear cell; Papillary; Renal cell carcinoma; Sorafenib; Sunitinib; Systemic therapy; Targeted therapy; Temsirolimus.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Antineoplastic Agents / therapeutic use*
Carcinoma, Renal Cell / drug therapy*
Carcinoma, Renal Cell / metabolism
Carcinoma, Renal Cell / pathology
Humans
Kidney Neoplasms / drug therapy*
Kidney Neoplasms / metabolism
Kidney Neoplasms / pathology
Molecular Targeted Therapy*

Substances

Antineoplastic Agents

Supplementary concepts

Clear-cell metastatic renal cell carcinoma