Sarcomatoid renal-cell carcinoma: treatment strategy, review of the literature and a case report Case report
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Abstract
Introduction: Sarcomatoid renal-cell carcinoma is a very rare cancer characterised with aggressive course of disease and poor prognosis. At present there are no standards of care for this histologic subtype of renal cell carcinoma resistant to various forms of systemic treatment.
Methods: The study describes a case of 58 year old woman after left nephrectomy for clear cell carcinoma with sarcomatoid component and after resection of right-kidney tumour for synchronous clear cell carcinoma who received first-line bevacizumab and temsirolimus under the clinical trial, and then second-line chemotherapy based on gemcitabine and doxorubicin and ifosfamide-based third-line chemotherapy. The patient underwent pulmonary metastasectomy twice, and once a metastasectomy for liver metastases.
Conclusions: Surgery (including metastases treatment) followed by the systemic chemotherapy seems to be correct option of treatment in patients with renal cell carcinoma with sarcomatoid features. The development of optimum method of systemic treatment requires further prospective randomised trials.
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
2. Haas NB., Lin X, Manola J et al. A Phase II Trial of doxorubicin and gemcitabine in renal cell carcinoma with sarcomatoid features: ECOG 8802. Med Oncol 2012; 29(2): 761-767. https://doi.org/10.1007/s12032-011-9829-8.
3. Dutcher JP, Nanus D. Long-term survival of patients with sarcomatoid renal cell cancer treated with chemiotherapy. Med Oncol 2011; 28(4): 1530-1533. https://doi.org/10.1007/s12032-010-9649-2.
4. Staehler M, Schoppler G, Haseke N et al. Sorafenib is superior to combination therapy with gemcitabine plus doxorubicin for patients with sarcomatoid renal cell carcinoma. Presented at the 2008 American Society of Clinical Oncology Genitourinary Cancer Symposium. San Francisco, California, February 14–16, 2008.
5. Staehler M, Haseke N, Roosen A et al. Sorafenib after combination therapy with gemcitabine plus doxorubicin in patients with sarcomatoid renal cell carcinoma: A prospective evaluation. Eur J Med Res 2010; 15(7): 287-291 https://doi.org/10.1186/2047-783X-15-7-287.
6. Golshayan AR, George S, Heng DY et al. Metastatic sarcomatoid renal cell carcinoma treated with vascular endothelial growth factor- targeted therapy. J Clin Oncol 2009; 27: 235-241.
7. Krzakowski M, Dziadziuszko R, Fijuth J et al. Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych. 2013; 1: 369-377.
8. Cheville JC, Lohse CM, Zinke H et al. Sarcomatoid renal cell carcinoma: an examination of underlying histologic subtype and an analysis of associations with patient outcome. Am J Surg Pathol. 2004; 28(4): 435-441.
9. Nanus DM, Garino A, Milowsky MI et al. Active chemotherapy for sarcomatoid and rapidly progressing renal cell carcinoma. Cancer 2004; 101: 1545-1551.
10. Motzer RJ, Mazumdar M, Bacik J et al. Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma. J Clin Oncol 1999; 17: 2530-2540.
11. Michaleson MD, McKay RR, Werner L et al. Phase 2 trial of sunitinib and gemcitabine in patients with sarcomatoid and/or poor-risk metastatic renal cell carcinoma. Cancer 2015; 121(19): 3435-3443. https://doi.org/10.1002/cncr.29503.