Background: Non-clear cell renal cell carcinoma (nccRCC) is a heterogeneous group of cancer. Treatment recommendations are extrapolated from ccRCC and lack solid evidence. Here, we review advanced nccRCC patients treated at our institute. Patients and methods: We collected retrospective data on all advanced nccRCC pts treated at the Istituto Oncologico Veneto from January 2008. We compared overall response rate (ORR), progression free survival (PFS) and overall survival (OS) according to histological subtypes and type of systemic treatments. Kaplan-Meier method, log-rank test and Cox regression were used to estimate and compare PFS and OS. Results: Of 1370 RCC patients, 289 had a diagnosis of nccRCC and 121 were eligible for the analysis. Fifty-three pts showed papillary histology (pRCC), 15 chromophobe; 37 unclassified RCC (NOS-RCC), 16 other histologies. Pts with chromophobe and other hystologies showed poorer survival rates compared to pRCC and NOS-RCC (mOS 10.7 vs. 20.7 vs. 30.7,p= 0.34). Pts treated with combination regimens achieved a better OS (30.7 vs. 13.7,p= 0.10), PFS (12.7 vs. 6.4,p= 0.10) and ORR (42.4% vs. 13.9%,p= 0.002) than those treated with monotherapy. IMDC and Meet-URO score retained their prognostic value. Conclusion: Our retrospective real-life cohort of advanced nccRCC patients shows that immunotherapy-based combinations could improve ORR, PFS and OS compared to TKI monotherapy. Prospective trials for nccRCC patients utilizing novel therapies are ongoing and their results eagerly awaited.
背景：非透明细胞肾细胞癌（nccRCC）是一组异质性肿瘤。其治疗建议多从透明细胞肾细胞癌（ccRCC）外推而来，缺乏坚实证据。本研究回顾性分析我院收治的晚期nccRCC患者情况。 患者与方法：收集2008年1月以来在威尼斯肿瘤研究所接受治疗的所有晚期nccRCC患者的回顾性数据。根据组织学亚型和全身治疗方案，比较总缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）。采用Kaplan-Meier法、时序检验和Cox回归模型评估并比较PFS和OS。 结果：在1370例肾细胞癌患者中，289例确诊为nccRCC，其中121例符合分析条件。53例为乳头状组织学类型（pRCC），15例为嫌色细胞型，37例为未分类肾细胞癌（NOS-RCC），16例为其他组织学类型。与pRCC和NOS-RCC相比，嫌色细胞型及其他组织学类型患者生存率较低（中位OS分别为10.7个月 vs. 20.7个月 vs. 30.7个月，p=0.34）。接受联合方案治疗的患者较单药治疗者获得更优的OS（30.7个月 vs. 13.7个月，p=0.10）、PFS（12.7个月 vs. 6.4个月，p=0.10）和ORR（42.4% vs. 13.9%，p=0.002）。IMDC和Meet-URO评分系统在本队列中保持预后价值。 结论：本真实世界回顾性队列研究表明，与TKI单药治疗相比，基于免疫治疗的联合方案可改善晚期nccRCC患者的ORR、PFS和OS。针对nccRCC患者的新型疗法前瞻性临床试验正在进行中，其结果值得期待。
肿瘤(癌症)患者之家