Sarcomatoid renal cell carcinoma (sRCC) is a rare and aggressive form of RCC in which the cells in the tumours look like the cells of a sarcoma (cancer of connective tissue such as muscles, nerves, fat, blood vessels etc.). Patients with metastatic RCC with sarcomatoid features are difficult to treat and do not respond well to anti-angiogenic targeted therapy, such as sunitinib and pazopanib. This meta-analysis of four studies with patients with sarcomatoid RCC shows promise with treatment with immune checkpoint inhibitor combinations.
There were 467 patients in the four studies in the final analysis: 226 patients were treated with immune checkpoint inhibitor combinations and 241 were treated with sunitinib. Immune checkpoint inhibitor combinations improved progression-free survival and overall survival compared with sunitinib, with a reduction of more than 40% in the risk of cancer progression and mortality. There was also an objective response rate of more than 50% with immunotherapy (versus 20% with sunitinib). Finally, immunotherapy significantly increased complete responses with an incidence of 11%.
In conclusion, these data support the use of immune checkpoint inhibitor combinations for the first-line treatment of sarcomatoid RCC.