Abstract
503 Background: The prognosis of renal cell carcinoma (RCC) patients with pancreatic metastases has been reported to be better amongst patients with metastatic disease in several series. However, the benefit of medical treatments, especially antiangiogenic (AA) therapy, is still poorly reported. Methods: We retrospectively reviewed clinical outcomes of RCC patients with pancreatic metastases treated with systemic treatments between 2000 and 2014. Results: Eighty-four patients (pts) were recorded, among which 24 underwent local treatment of pancreatic metastases (83% surgery). Clear cell histology accounts for 92%. At the initiation of systemic treatment, prognostic score according to IMDC was good, intermediate, or unknown in 36%, 50%, and 13% respectively. Median overall survival (OS) was 83,2 months (mo) (55.6-29.4). Median OS was 127 mo (106.6-not reached [NR]) for patients who underwent a local treatment on the pancreas vs. 56.5 (39.8-NR) for those who did not (p=0.04). Cytokines used as first-line systemic therapy (n=27, 52% interleukin-2-based, 22% good prognostic group, 59% intermediate, 19% unknown) yielded an overall response rate (ORR) of 26%, a median treatment duration of 5.4 months (mo) (4.7-5.9) and a time to treatment failure (TTF) of 14.5 mo (12-32.2). Patients who received AA (n=77, previous cytokines 25%) showed, for the first use of AA, an ORR of 61%, with a median treatment duration of 11.5 mo (9-14.7) and a TTF of 18.2 mo (12.4-25.8). OS from the time of first systemic therapy was 107 mo (63.8-140.4) in patients who received AA vs. 30 mo (5.4-NR) in those who did not (p=3.10-5). Conclusions: This study confirms the more favorable prognosis of patients with pancreatic metastases from RCC. ORR to both cytokines and AA is higher than that observed in a general population of patients with metastatic RCC. The molecular basis for this observed better outcome deserves further investigation.
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