Survival Rates in High-Risk Non-Clear Cell RCC Comparable to Clear Cell RCC With Adjuvant Pembrolizumab Therapy

Data from a recent multicenter study revealed that although the majority of clinical trials exploring adjuvant therapy for the treatment of renal cell carcinoma (RCC) concentrate on clear cell (ccRCC), patients with high-risk non-clear cell RCC (nccRCC) exhibit comparable 5-year cancer-specific and overall survival outcomes. These findings highlight that patients with nccRCC may benefit from adjuvant therapy, potentially enhancing long-term survival rates.

The study findings were based on data from 6,014 non-metastatic RCC patients from various international centers who underwent nephrectomy. Researchers compared cancer-specific and overall survival rates of patients with high-risk localized ccRCC and nccRCC.

Dr. Giacomo Musso, from the Department of Urology, IRCCS San Raffaele Scientific Institute and the Urological Research Institute, Division of Experimental Oncology, Milan, Italy, presented the findings at the recent 25^th Annual Meeting of the Society of Urologic Oncology.

During an average follow-up of 61 months, 6,014 patients with different types of RCC, including 4,759 patients with ccRCC, 932 papillary, 241 chromophobe, and 82 variant-histology RCCs, were monitored.

Data revealed no significant variances in survival rates between high-grade nccRCC and high-grade ccRCC. In particular, the 5-year cancer-specific survival (CSS) rates were 91% for high-grade nccRCC and 88% for high-grade ccRCC, with a P value of 0.08.

The 5-year overall survival (OS) rates were identical at 79% (P=.1). Among patients with positive lymph nodes, the 5-year CSS was 50% for nccRCC and 52% for ccRCC (P=.07), with the 5-year OS rates reported as 38% for nccRCC and 37% for ccRCC (P=.6).

Regarding T3-stage tumors, the 5-year CSS rates were comparable at 83% and 84% for nccRCC and ccRCC (P=.05), respectively, with the 5-year OS rates as 73% for both (P=.2).

The Cox regression analysis disclosed that histology was not an independent predictor of cancer-specific mortality or all-cause mortality, with P values of .17 and .11, respectively.

The findings from this study accentuate the importance of conducting additional clinical trials to ascertain the efficacy of adjuvant systemic therapy for high-risk nccRCC patients.

Reference

Musso G. Meagher M. Yuen K. et al. Comparative Survival Outcomes of Non-Clear Cell Renal Cell Carcinomas and Clear Cell Renal Cell Carcinomas with Indications for Adjuvant Pembrolizumab. Poster #50. Presented at the 25th Annual Meeting of the Society of Urologic Oncology; December 4-6, 2024; Dallas, Texas.