title: Outcome of Patients With Metastatic Chromophobe Renal Cell Carcinoma Treated With Sunitinib.
abstract: Sunitinib is a standard treatment for metastatic clear cell renal cell carcinoma (mccRCC). Data on its activity in the rare variant of metastatic chromophobe renal cell carcinoma (mchRCC), are limited. We aimed to analyze the activity of sunitinib in a relatively large and homogenous international cohort of mchRCC patients in terms of outcome and comparison with mccRCC.
  
  
  
  Records from mchRCC patients treated with first-line sunitinib in 10 centers across 4 countries were retrospectively reviewed. Univariate and multivariate analyses of association between clinicopathologic factors and outcome were performed. Subsequently, mchRCC patients were individually matched to mccRCC patients. We compared the clinical benefit rate, progression-free survival (PFS), and overall survival (OS) between the groups.
  
  
  
  Between 2004 and 2014, 36 patients (median age, 64 years; 47% male) with mchRCC were treated with first-line sunitinib. Seventy-eight percent achieved a clinical benefit (partial response + stable disease). Median PFS and OS were 10 and 26 months, respectively. Factors associated with PFS were the Heng risk (hazard ratio [HR], 3.3; p = .03) and pretreatment neutrophil-to-lymphocyte ratio (NLR) >3 (HR, 0.63; p = .02). Factors associated with OS were the Heng risk (HR, 4.1; p = .04), liver metastases (HR, 3.8; p = .03), and pretreatment NLR <3 (HR, 0.55; p = .03). Treatment outcome was not significantly different between mchRCC patients and individually matched mccRCC patients. In mccRCC patients (p value versus mchRCC), 72% achieved a clinical benefit (p = .4) and median PFS and OS were 9 (p = .6) and 25 (p = .7) months, respectively.
  
  
  
  In metastatic chromophobe renal cell carcinoma, sunitinib therapy may be associated with similar outcome and toxicities as in metastatic clear cell renal cell carcinoma. The Heng risk and pretreatment NLR may be associated with PFS and OS.
  
  
  
  Data on the activity of sunitinib in metastatic chromophobe renal cell carcinoma (mchRCC) are limited. This study analyzed the activity of sunitinib in a cohort of mchRCC patients. Of 36 patients with mchRCC who were treated with first-line sunitinib, 78% achieved a clinical benefit. Median PFS and OS were 10 and 26 months, respectively. Treatment outcome was not significantly different between mchRCC patients and individually matched metastatic clear cell RCC patients.
authors.affiliation: Department of Oncology, Meir Medical Center, Kfar Saba, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel danielkeizman@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Keizman
authors.affiliation: Department of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Sarid
authors.affiliation: Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Jae L
authors.initials: JL
authors.lastname: Lee
authors.affiliation: Department of Oncology, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Avishay
authors.initials: A
authors.lastname: Sella
authors.affiliation: Department of Oncology, Meir Medical Center, Kfar Saba, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Maya
authors.initials: M
authors.lastname: Gottfried
authors.affiliation: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA.
authors.forename: Hans
authors.initials: H
authors.lastname: Hammers
authors.affiliation: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Eisenberger
authors.affiliation: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Carducci
authors.affiliation: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA.
authors.forename: Victoria
authors.initials: V
authors.lastname: Sinibaldi
authors.affiliation: Department of Oncology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Victoria
authors.initials: V
authors.lastname: Neiman
authors.affiliation: Department of Oncology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Rosenbaum
authors.affiliation: Department of Oncology, Rambam Medical Center, Haifa, Israel.
authors.forename: Avivit
authors.initials: A
authors.lastname: Peer
authors.affiliation: Department of Oncology, Rambam Medical Center, Haifa, Israel.
authors.forename: Avivit
authors.initials: A
authors.lastname: Neumann
authors.affiliation: Department of Oncology, Soroka Medical Center, Beersheba, Israel.
authors.forename: Wilmosh
authors.initials: W
authors.lastname: Mermershtain
authors.affiliation: Department of Oncology, Soroka Medical Center, Beersheba, Israel.
authors.forename: Keren
authors.initials: K
authors.lastname: Rouvinov
authors.affiliation: Department of Oncology, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Raanan
authors.initials: R
authors.lastname: Berger
authors.affiliation: Acibadem University Atakent Hospital, Istanbul, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yildiz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011758:Pyrroles / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077210:Sunitinib; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib
keywords: Chromophobe type; Clear cell type; Metastatic renal cell carcinoma; Outcome; Sunitinib