Renal medullary carcinoma (RMC) is an extremely rare and aggressive form of kidney cancer. It is almost exclusively found in young people who carry the sickle cell gene. The sickle cell gene is particularly common in people with an African or Caribbean family background and can cause a group of inherited conditions that affect the red blood cells, causing anaemia.
Studies have suggested that RMC cells could response to treatments that damage DNA, such as a combination of the chemotherapies gemcitabine and doxorubicin.
In this study, the records of patients with RMC treated with gemcitabine plus doxorubicin were assessed. There were 16 patients in the study, and all but one patient had been treated with prior platinum-based chemotherapy. The chemotherapy was given intravenously every 2 weeks. Three patients (18.8%) had a partial response to treatment and 7 (43.8%) patients had stable disease. The average time to when the cancer started growing again and the treatment stopped working (progression-free survival) was 2.8 months, average overall survival time was 8.1 months and average overall survival time from diagnosis was 15.5 months.
There were no life-threatening side effects. Severe side effects included low blood cell counts (18.8%), nausea (12.5%), fatigue (12.5%), and damage to the heart (6.2%).
This study show that gemcitabine plus doxorubicin is well tolerated and effective in RMC patients who are no longer responding to treatment with platinum-based chemotherapy. Some patients had a response to treatment that lasted longer than 6 months. Further studies are needed to look for biomarkers and why patients stop responding to treatment.