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Cabozantinib in Pretreated Patients with Metastatic Renal Cell Carcinoma with Sarcomatoid Differentiation: A Real-World Study

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Abstract

Background

Renal cell carcinoma with sarcomatoid differentiation is a highly aggressive form of kidney cancer.

Objective

We aimed to analyze the outcomes of patients treated with cabozantinib for metastatic renal cell carcinoma with sarcomatoid features.

Methods

We retrospectively collected data from 16 worldwide centers. Overall survival and progression-free survival were analyzed using Kaplan–Meier curves. Cox proportional models were used for univariate and multivariate analyses.

Results

We collected data from 66 patients with metastatic sarcomatoid renal cell carcinoma receiving cabozantinib as second-line (51%) or third-line (49%) therapy. The median progression-free survival from the start of cabozantinib was 7.59 months (95% confidence interval [CI] 5.75−17.49) and was longer in male patients (8.81 vs 5.95 months, p = 0.042) and in patients without bone metastases (7.59 vs 5.11 months, p = 0.010); the median overall survival was 9.11 months (95% CI 7.13−23.80). At the multivariate analysis, female sex (hazard ratio = 1.81; 95% CI 1.02−3.37, p = 0.046), bone metastases (hazard ratio = 2.62; 95% CI 1.34−5.10, p = 0.005), and International Metastatic Renal Cell Carcinoma Database Consortium criteria (hazard ratio = 3.04; 95% CI 1.54−5.99, p = 0.001) were significant predictors of worse overall survival.

Conclusions

Our data show that cabozantinib is active in pretreated patients with sarcomatoid renal cell carcinoma. Biomarkers are needed in this field to select patients for multi-kinase inhibitors or other options.

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Authors and Affiliations

  1. Oncology Unit, Macerata Hospital, Macerata, Italy

    Matteo Santoni & Nicola Battelli

  2. Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

    Francesco Massari, Veronica Mollica & Alessandro Rizzo

  3. Department of Medical Oncology, MD Anderson Cancer Center Madrid, Madrid, Spain

    Enrique Grande

  4. Department of Medical Oncology, Istituto Nazionale dei Tumori IRCCS, Milan, Italy

    Giuseppe Procopio

  5. Department of Internal Medicine, Hematology/Oncology, Ochsner Medical Center, New Orleans, LA, USA

    Marc R. Matrana & Fady Farag

  6. Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, Pavia, Italy

    Mimma Rizzo

  7. Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy

    Ugo De Giorgi

  8. Department of Medical Oncology, Istituto Oncologico Veneto (IOV) IRCCS, Padua, Italy

    Umberto Basso

  9. U.O.C. Oncology, Azienda Ospedaliera Universitaria Integrata, University and Hospital Trust of Verona, Verona, Italy

    Michele Milella

  10. Medical Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Roberto Iacovelli

  11. Medical Oncology Division of Urogenital and Head and Neck Tumours, IEO, European Institute of Oncology IRCCS, Milan, Italy

    Gaetano Aurilio

  12. Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy

    Lorena Incorvaia

  13. Medical Oncology Unit, University Hospital of Parma, Parma, Italy

    Sebastiano Buti

  14. Medical Oncology Department, Santa Chiara Hospital, Trento, Italy

    Orazio Caffo

  15. Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Giuseppe Fornarini

  16. Oncology Unit, City Hospital, Faenza, Italy

    Francesco Carrozza

  17. Department of MedicalOncology, Hospital Ramón y Cajal, Madrid, Spain

    Javier Molina-Cerrillo

Authors
  1. Matteo Santoni
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  2. Francesco Massari
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  3. Enrique Grande
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  4. Giuseppe Procopio
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  6. Mimma Rizzo
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  7. Ugo De Giorgi
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  8. Umberto Basso
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  9. Michele Milella
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  10. Roberto Iacovelli
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  11. Gaetano Aurilio
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  12. Lorena Incorvaia
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  13. Sebastiano Buti
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  14. Orazio Caffo
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  15. Giuseppe Fornarini
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  16. Francesco Carrozza
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  17. Veronica Mollica
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  18. Alessandro Rizzo
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  19. Fady Farag
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  20. Javier Molina-Cerrillo
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  21. Nicola Battelli
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Corresponding author

Correspondence to Matteo Santoni.

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Funding

No external funding was used in the preparation of this article.

Conflicts of interest/Competing interests

Matteo Santoni, Francesco Massari, Enrique Grande, Giuseppe Procopio, Marc R. Matrana, Mimma Rizzo, Ugo De Giorgi, Umberto Basso, Michele Milella, Roberto Iacovelli, Gaetano Aurilio, Lorena Incorvaia, Sebastiano Buti, Orazio Caffo, Giuseppe Fornarini, Francesco Carrozza, Veronica Mollica, Alessandro Rizzo, Fady Farag, Javier Molina-Cerrillo, and Nicola Battelli have no conflicts of interest that are directly relevant to the content of this article.

Ethics approval

The research was carried out in accordance with the approval by the ethical committee of the participating institutions.

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Author contributions

MS designed and directed the project. MS, VM, AR, and FM wrote the article and performed the statistical analysis. EG, GP, MRM, MR, UDG, UB, MM, RI, GA, LI, SB, OC, GF, FC, FF, and JM-C collected data from their centers for the retrospective analysis. EG, GP, MRM, and NB were responsible for the final revision.

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Santoni, M., Massari, F., Grande, E. et al. Cabozantinib in Pretreated Patients with Metastatic Renal Cell Carcinoma with Sarcomatoid Differentiation: A Real-World Study. Targ Oncol 16, 625–632 (2021). https://doi.org/10.1007/s11523-021-00828-z

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  • DOI: https://doi.org/10.1007/s11523-021-00828-z

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