Efficacy of sorafenib in treating metastatic renal cell carcinoma with sarcomatoid feature

Abstract

Objective To evaluate the efficacy of sorafenib in treating metastatic renal cell carcinoma with sarcomatoid feature.Methods Fourteen patients with metastatic renal cell carcinoma and previous nephrectomy were treated with sorafenib single agent.The average age was 61 years(45-77years).All patients were pathologically confirmed with sarcomatoid features in the primary tumors and the percentage of sarcomatoid element was recorded from 20% to 100%.Eight cases were diagnosed as clear cell carcinoma with sarcomatoid feature,2 cases papillary renal cell carcinoma (RCC) with sarcomatoid feature,and 4 cases with pure sarcomatoid RCC.The metastatic lesions were located at lung,lymph node,adrenal gland,bone,and liver.The median time of treatment was 8 months (3-19 months).Results Two cases who just had lymph node metastasis reached partial remission.Their percentages of sarcomatoid lesion were 100% and 20%.Seven cases maintained stable disease for more than 12 weeks and the last 5 cases progressed.To Jul 2009,9 patients progressed and the median progression free survival was 6 months(0-19 months).No significant correlation was seen between both objective response rate and progression free survival and the percentage of sarcomatoid element.Conclusions Although sorafenib has some effect in advanced renal cell carcinoma with sarcomatoid feature,the prognosis of these patients is relatively poor.The percentage of sarcomatoid element does not seem to correlate with the treatment efficacy. Key words: Carcinoma,renal cell; Sarcoma; Neoplasm metastasis; Sorafenib