Abstract
Non-clear cell RCC (nccRCC) represents a heterogenous group of tumors which is less well studied than clear cell RCC. Clinical data supporting the treatment of nCCRCC are still based predominantly on clinical trials conducted in ccRCC. There is very little known about this group of patients in Asia. In this study, we aim to report the real world outcomes of nCCRCC patients in a cancer centre in Singapore. We conducted a retrospective analysis on 99 non-clear cell RCC patients treated at the National Cancer Centre Singapore from 2009-2018. Data on patient demographics, disease characteristics, treatment outcomes and adverse events were collected retrospectively up till March 2020. Overall survival (OS) and progression free survival (PFS) were estimated using the Kaplan-Meier method. Responses to treatment were recorded based on RECIST v1.1 and analyzed using logistic regression. 99 patients were included in this analysis, with a median age at diagnosis of 56.7 years old. Papillary RCC accounted for 30.3% (n=30) of the cases, chromophobe RCC for 2% (n=2), unclassified RCC for 56.6% (n=56) and other subtypes for 11.1% (n=11). Median follow-up time was 24 months. Among this cohort, 72 patients (73%) received tyrosine kinase inhibitors (TKI), 14 patients (14%) had cytokine while 13 patients (13%) undergone other treatment. Median OS for the cohort was 13.4 months, while median PFS was 2.82 months. Overall response rate (CR/PR) for first-line treatment was 20.2%. In terms of safety outcomes, 29.3% of patients experienced severe adverse events (Grade 3 and above) while undergoing treatment. The most common adverse events severe reported were hand-foot syndrome (5.05%) and diarrhoea (4.04%). This real-world study provides important data regarding clinical outcomes in this rare and heterogeneous group of renal cell carcinoma patients. There relatively modest survival outcomes reflect the need to better therapies for this patient group.
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