Search

Introduction: We aimed to evaluate clinical features, prognostic factors, and treatment preferences in patients with non-clear cell renal cell carcinoma (nccRCC). Methods: Patients with metastatic nccRCC were selected from the Turkish Oncology Group Kidney Cancer Consortium (TKCC) database. Clinical features, prognostic factors, and overall survival (OS) outcomes were investigated. Results: A total of 118 patients diagnosed with nccRCC were included in this study. The median age at diagnosis was 62 years (interquartile range: 56–69). Papillary (57.6%) and chromophobe tumors (12.7%) are common histologic subtypes. Sarcomatoid differentiation was present in 19.5% of all patients. When the patients were categorized according to the International Metastatic RCC Database Consortium (IMDC) risk scores, 66.9% of the patients were found to be in the intermediate or poor risk group. Approximately half of the patients (55.9%) received interferon in the first line. At the median follow-up of 53.2 months (95% confidence interval [CI]: 34.7–71.8), the median OS was 19.3 months (95% CI: 14.1–24.5). In multivariate analysis, lung metastasis (hazard ratio [HR]:2.22, 95% CI: 1.23–3.99) and IMDC risk score (HR: 2.35, 95% CI: 1.01–5.44 for intermediate risk; HR: 8.86, 95% CI: 3.47–22.61 for poor risk) were found to be independent prognostic factors. Conclusion: In this study, survival outcomes are consistent with previous studies. The IMDC risk score and lung metastasis are the independent prognostic factors for OS. This is an area that needs research to better treat this group of patients and create new treatment options.

Renal cell carcinoma is the fourteenth most common cancer in the world with a male to female ratio of 2:1, and clear cell renal cell carcinoma (ccRCC) is the most common histological subtype. Nivolumab is preferred as subsequent therapy in patients with metastatic ccRCC who show progress after at least one line of anti-vascular endothelial growth factor (anti-VEGF) agents. For several decades, removal of the primary tumor, called cytoreductive nephrectomy, was the cornerstone in the treatment of newly diagnosed metastatic ccRCC. There is limited information about how cytoreductive nephrectomy affects survival outcomes in metastatic ccRCC patients treated with nivolumab. In our study, we aimed to investigate the effect of cytoreductive nephrectomy on nivolumab survival outcomes in metastatic ccRCC patients. Our study included 106 de novo metastatic ccRCC patients with a history of nephrectomy at the time of diagnosis from 20 oncology centers in the Turkish Oncology Group. Multivariate Cox regression analysis was performed to investigate the factors affecting survival in patients receiving nivolumab. The median age of the patients was 60.0 (minimum 18.7-maximum 79.2) years. Eighty-three (78.3%) of the patients had undergone cytoreductive nephrectomy. The median overall survival (OS) of the patients receiving nivolumab was 22.7 months (95% CI 16.1–29.3), and the median time-to-treatment discontinuation (TTD) was 12.0 months (95% CI 8.7–15.3). In the multivariate analysis, cytoreductive nephrectomy (p = 0.011) and the International Metastatic RCC Database Consortium (IMDC) risk score (p = 0.024) were among the significant factors affecting TTD, and the IMDC risk score (p = 0.006) was among the significant factors affecting OS. Our study showed that TTD of nivolumab was longer in metastatic ccRCC patients treated with cytoreductive nephrectomy and progressed after at least one line of anti-VEGF agents.

Background: A novel prognostic model was recommended for patients with metastatic RCC (mRCC) by the International mRCC Database Consortium (IMDC). In this study, we aimed to externally validate a novel risk model for the IMDC-favorable risk group in patients with mRCC. Methods: The Turkish Oncology Group Kidney Cancer Consortium (TKCC) is a multicenter registry that includes 13 cancer centers in Turkey. As described by Schmidt et al., 3 parameters (ie, time from diagnosis to systemic therapy 80, and the presence of brain, liver, or bone metastasis) were used to divide the IMDC favorable risk group into 2 new categories: very favorable and favorable risk groups. The primary endpoint was overall survival (OS). Time to treatment failure (TTF) and objective response rate (ORR) in the very favorable and favorable risk groups were the secondary endpoints. Results: A total of 545 patients with mRCC from all IMDC risk groups and 112 patients from the favorable risk group were included in this study. According to the novel classification model, 44 (39.3%) and 68 (60.7%) patients with former favorable risk were categorized into very favorable and favorable risk groups, respectively. The median OS (55.8 months vs. 34.2 months, P = .025) and TTF (25.5 months vs. 15.5 months, P = .010) were longer in the very favorable risk group than in the favorable risk group. The concordance index of the new IMDC model in all patients was 0.65 for OS. Despite the higher ORR in the very favorable risk group than in the favorable risk group, the difference between the groups was not statistically significant (52.4% vs. 44.7, P = .573). Conclusions: This was the first study to externally validate the novel IMDC risk model presented in the American Society of Clinical Oncology Genitourinary Cancers Symposium 2021. 35970759

Background Pan-immune-inflammation value (PIV) is an easily accessible immune marker based on peripheral blood to estimate prognosis in patients with cancer. This study evaluates the prognostic value of PIV in patients with metastatic renal cell carcinoma (mRCC) treated with nivolumab. Methods In this retrospective cohort study, patients with mRCC treated with nivolumab in the second line and beyond were selected from the Turkish Oncology Group Kidney Cancer Consortium (TKCC) database. PIV was calculated by using the following formula: neutrophil (103/mm3) x monocyte (103/mm3) x platelet (103/mm3) / lymphocyte (103/mm3). Results A total of 152 patients with mRCC were included in this study. According to cut-off value for PIV, 77 (50.7%) and 75 (49.3%) patients fell into PIV-low (\(\le\)372) and PIV-high (>372) groups, respectively. In multivariate analysis, PIV-high (HR:1.64, 95% CI: 1.04–2.58, p = 0.033 for overall survival (OS); HR:1.55, 95% CI: 1.02–2.38, p = 0.042 for progression-free survival (PFS)) was independent risk factor for OS and PFS after adjusting for confounding variables such as performance score, the International mRCC Database Consortium (IMDC) risk score, and liver metastasis. Conclusion This study established that pre-treatment PIV might be a prognostic biomarker in patients with mRCC treated with nivolumab in the second line and beyond.

Introduction: The case of a patient who developed recurrent delayed immune-related pneumonitis (checkpoint inhibitor pneumonitis [CIP]) after immune checkpoint inhibitor (ICI) therapy for advanced osteosarcoma treatment is presented. Case summary: A 25-year-old female patient with metastatic osteosarcoma was treated with atezolizumab. Grade 2 pneumonitis developed three times in the first two years. Treatment was discontinued after recovery from the last episode of pneumonitis, which was complicated with secondary spontaneous pneumothorax. 2 years after discontinuation of immunotherapy, the patient again developed CIP. Pneumonitis symptoms were regressed with oral steroid therapy during follow-up and a stable disease response continued. Conclusion: Immunotherapy can cause recurrent CIP at any time during the treatment period or after discontinuation of treatment.

Aim: To investigate the prognostic value of the systemic immune-inflammation index (SII) and its impact on survival in patients with metastatic renal cell carcinoma (mRCC).Methods: A total of 706 patients with mRCC treated with tyrosine kinase inhibitors (TKIs) (i.e., sunitinib, pazopanib) were retrospectively analyzed. All patients were classified into either a high-SII group or a low-SII group based on the cut-off value of SII at 756, which was the median SII level of our study group. Results: The median age of patients was 60 (interquartile range (IQR):53-67) years. Three out of four patients were male. The majority of patients (85.7%) had clear cell histology, and sarcomatoid differentiation was observed in 16.9% of all patients. The rates of patients in favorable, intermediate, and poor “International mRCC Database Consortium (IMDC)” risk groups were 20.1%, 57.6%, and 22.2%, respectively. There were 311 and 310 patients in the SII-low and SII-high groups, respectively. At the median of 48.6 months follow-up, the median overall survival (OS) was 34.6 months and 14.5 months in the low- and high-SII groups, respectively (pConclusion: Pre-treatment level of high SII might be considered as a predictor of poor prognosis in patients with mRCC treated with TKIs.

To evaluate clinical and demographic characteristics and the results of cytotoxic treatments ofNGS data of 1264 patients with non-small cell lung cancer were retrospectively evaluated. Among these patients, the mutation distributions of 1081 patients with metastatic lung adenocarcinoma were analyzed. A total of 150 patients with negative NGS panel or mutantIn 1081 patients who underwent NGS from tumor tissue with the diagnosis of metastatic lung adenocarcinoma, 296 (27%) NGS panel negative and 276 (26%)There is no difference in overall survival, first-line chemotherapy response, or progression-free survival among patients with NGS panel negative