Potentially curable gastric adenocarcinoma (GAC) patients treated without surgery.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 120-120
Author(s):  
Dilsa Mizrak Kaya ◽  
Graciela M. Nogueras-Gonzalez ◽  
Jeannelyn Estrella ◽  
Kazuto Harada ◽  
Fatemeh Ghazanfari Amlashi ◽  
...  
Keyword(s):  
Performance Status ◽  
Poor Performance ◽  
Female Gender ◽  
Complete Response ◽  
Signet Ring Cell ◽  
Poor Performance Status ◽  
Entire Cohort ◽  
Signet Ring ◽  
Ring Cell ◽  
Patient Refusal

120 Background: Surgery is the best option to cure localized GAC. When surgery is not possible due to comorbidities or patient refusal, definitive chemoradiation is an option. We report on one of the largest cohorts of GAC patients who did not have surgery. Methods: We identified 71 patients with localized GAC who received chemo/chemoradiation therapy but did not have surgery. We assessed various endpoints (overall survival [OS] and recurrence-free survival [RFS]). Clinical complete response (cCR; negative post therapy biopsy and no evidence of cancer by imaging) was also assessed. Results: The median follow-up time was 1.8 years (range; 0.4-10.6). Most of the patients were men (64.8%) and the median age was 73 years (range; 30-96). Reason for not having surgery included comorbidities in 34 (47.9%), poor performance status 14 (19.7%), and patient refusal 23 (32.4%). Most of the patients (80.3%) received chemoradiation and 14 (19.7%) could receive only chemotherapy. Of all 71 patients, 32 (45.1%) achieved to a cCR. For the entire cohort, the median OS was 2.1 years (95% Cl 0.98-1.02). The estimated OS rates at 2 and 5 years were 46.5% and 11.3%, respectively. The median OS and the median RFS for patients with cCR were 2.3 and 1.8 years (95% Cl 0.97-1.01), respectively. Female gender (HR 0.47, 95% Cl 0.25-0.91, p = 0.024) and chemoradiation (HR 0.36, 95% Cl 0.16-0.85; p = 0.019) were independently associated with longer OS in the multivariate analysis. Histologic grade and the presence of signet ring cell had no effect on OS. Conclusions: Our data show that patients with localized GAC who do not undergo surgery have a low but measurable 5-year OS rate of 11.3%.

scholarly journals Evaluation of Traditional Prognostic Factors for Stage I-III Colorectal Cancer Patients Who Survived for Over Five Years After Surgery

2021 ◽  
Vol 11 ◽  
Author(s):  
Dakui Luo ◽  
Yufei Yang ◽  
Zezhi Shan ◽  
Qi Liu ◽  
Sanjun Cai ◽  
...  
Keyword(s):  
Vascular Invasion ◽  
Perineural Invasion ◽  
Cox Regression ◽  
Signet Ring Cell ◽  
Stage I ◽  
Regression Analyses ◽  
Pathological Stage ◽  
Entire Cohort ◽  
Signet Ring ◽  
Ring Cell

The aim of this study was to explore the prognostic factors in stage I-III colorectal cancer (CRC) patients who had survived for over five years. A total of 9754 stage I-III CRC patients who received curative surgery in the Department of Colorectal Surgery, Fudan University Shanghai Cancer Center were enrolled in this study. Of them, 3640 patients had survived for over five years after surgery. Univariate and multivariate Cox regression analyses were performed in the entire cohort and those who had survived for over five years. Compared with patients in the entire cohort, patients who had survived for over five years were more likely to be younger, have less disease of signet ring cell histology, perineural invasion and vascular invasion, more well differentiated tumors and stage I disease. In the entire cohort, increased age, signet ring cell, poor differentiation, more advanced pathological stage, perineural invasion and vascular invasion were inversely associated with disease-free survival (DFS) and overall survival (OS) using multivariable Cox regression analyses. Only age, pathological stage and perineural invasion remained significant in patients who had survived for over five years. Moreover, tumor location was an independent factor for OS in this subgroup. Predictors for prognosis of CRC change over time. Age, pathological stage and perineural invasion deserve more attention among patients who have survived for over five years.

Phase II Study of Gemtuzumab Ozogamycin (GO) and Cytarabine (ARA-C) in Patients with High Risk MDS and AML..

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4723-4723
Author(s):  
Peter Kang ◽  
Karen Seiter ◽  
Delong Liu ◽  
Muhammad Arshad ◽  
Anila Qureshi ◽  
...  
Keyword(s):  
High Risk ◽  
Performance Status ◽  
Poor Performance ◽  
Complete Response ◽  
Lung Damage ◽  
Poor Performance Status ◽  
High Cumulative Dose ◽  
History Of ◽  
M 12 ◽  
To Receive

Abstract To evaluate the efficacy of GO + ara-c in high risk pts, we treated 22 pts with MDS (10) and AML (12) with cytarabine 100 mg/m2/d x 7 d and GO 9 mg/m2 x 1 on d 4. Pts with MDS were eligible if they had [1] RAEB-1 and either hgb < 8 gm/dl, platelet < 50,000/mm3, neutrophils < 1000/mm3, or cytogenetics other than 5q-, 20q-, -y, or normal, [2] RAEB-2, or [3] CMML. Pts with AML (newly diagnosed or relapsed) were eligible if they were ineligible for anthracycline-based therapy (poor performance status: 2 pts; low ejection fraction or high cumulative dose of anthracyclines: 6 pts, both reasons: 4 pts). The median age was 66, M:12, F:10. Diagnoses: RAEB-1: 4, RAEB-2: 5, CMML: 1, AML, newly dx’d: 7, AML relapsed: 5. Cytogenetics were high risk: 10, intermediate risk: 11 pts, low risk: 1 pt. Overall, 18% had a complete response (CR) after one cycle of therapy. Three pts (14%) had a partial response (PR), of which one had a CR after a second course of therapy. Of the pts with AML: CR: 2/12, PR: 2/12, Failure (F): 5/12, Toxic Death (TD): 3/12. For pts with MDS: CR: 2/10, PR: 1/10, F: 5/10, TD: 2/10. Toxicities included neutropenic fever/sepsis, mucositis, diarrhea, increased LFTs, hemorrhage. One pt with a history of ABVD and RT to chest for HD developed direct pulmonary toxicity due to chemotherapy (diffuse pulmonary infiltrates, biopsy proven toxic lung damage). Although overall response rate is modest, some pts had remarkable responses: One pt with RAEB-1, transfusion dependent and multiple high risk cytogenetics (−5, −7, multiple others) remains in CR (including cytogenetic CR) 7 months post treatment. A second pt with RAEB-1, transfusion dependent and multiple high risk cytogenetics (−5, −7, multiple others) had a PR after one course, but was unable to receive further chemotherapy due to toxicity. The latter pts suggest that this regimen should be studied further in pts with MDS, poor risk cytogenetics and low blast counts.

Current trend in incidence of severe interstitial lung disease (ILD) due to gefitinib in Japan

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e19075-e19075
Author(s):  
K. Goto ◽  
H. Kenmotsu ◽  
Y. Nishiwaki ◽  
K. Kubota ◽  
H. Ohmatsu ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Performance Status ◽  
Current Trend ◽  
Poor Performance ◽  
Female Gender ◽  
Patient Characteristics ◽  
Japanese Patients ◽  
Cancer Center ◽  
Poor Performance Status ◽  
Almost All

e19075 Background: Although gefitinib is a promising agent for the treatment of advanced non-small cell lung cancer, ILD occurs in Japanese patients and sever ILD sometimes becomes fatal toxicity. ILD has been reported to be associated with preexisting ILD, smoking, and poor performance status. On the other hand, it has been reported that female gender, adenocarcinoma, non-smoker, and EGFR mutation are associated with sensitivity to gefitinib. Methods: To investigate the trend in incidence of severe ILD and patient characteristics receiving gefitinib, a total of 751 patients who were administered gefitinib in National Cancer Center Hospital East between 2002 and 2008 were retrospectively reviewed. To investigate how oncologists avoid administering gefitinib to patients with preexisting ILD, pretreatment chest CT films of all patients were also reviewed by two thoracic radiologists. Results: The patient number who received gefitinib in 2002/2003/2004/2005/2006/2007/2008 were 134/141/88/93/125/98/72, respectively. In these patients, percentages of female were 36/43/42/55/59/52/54%, adenocarcinoma 76/78/93/88/95/93/92%, non-smoker 35/30/40/53/49/48/46%, respectively. Almost all of the patient receiving gefitinib was recently restricted to adenocarcinoma. Grade 3–5 severe ILD was observed in 1.9% of all patients. However, the incidence rate of sever ILD were decreased as 3.0/2.8/2.3/1.1/0.8/1.0/1.4%, respectively. The rates of patients with preexisting ILD were also decreased as 22/14/15/5/2/3/6%, respectively. Conclusions: The correct information about efficacy and severe ILD about gefitinib influenced patient selection by oncologists, and it is reasonable to select more effective and safe patients in Japan. It is estimated that the incidence rate of severe ILD should be consequently controlled by the spread of these information. No significant financial relationships to disclose.

scholarly journals Sarcomatoid carcinoma presenting as cancers of unknown primary: a clinicopathological portrait

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ryan W. Huey ◽  
Shalini Makawita ◽  
Lianchun Xiao ◽  
Aurelio Matamoros ◽  
Jeannelyn S. Estrella ◽  
...  
Keyword(s):  
Molecular Diagnostics ◽  
Performance Status ◽  
Sarcomatoid Carcinoma ◽  
Poor Performance ◽  
Rank Test ◽  
Unknown Primary ◽  
Trial Participation ◽  
Poor Performance Status ◽  
Rare Presentation ◽  
Entire Cohort

Abstract Background Sarcomatoid carcinoma of unknown primary (SCUP) is a rare entity of either poorly differentiated carcinoma with sarcoma-like differentiation or a true mixed lineage neoplasm. Limited data regarding clinicopathological profile and management exists. Methods We retrospectively reviewed the MD Anderson Cancer of Unknown Primary database and tumor registry to identify 48 SCUP patients between 2001 and 2017. Patient characteristics, pathology, molecular diagnostics, treatments, and outcomes were obtained. Kaplan-Meier method was used to estimate overall survival (OS) and compared using log rank test. Results Median age at diagnosis was 59 years (range 27–86). Majority of patients were female (58%) and presented with ≥3 metastatic sites (52%), commonly lymph node (50%), bone (42%), lung (27%), and liver (21%). First line treatment included chemotherapy (35%), surgery (27%), and radiation (24%). Gemcitabine and docetaxel (18%) was the most common chemotherapy regimen. Median OS for entire cohort was 11 months (95% CI: 5.6 to 16.4). Poor performance status (PS), > 1 metastatic site, elevated lactate dehydrogenase (LDH), and high neutrophil-to-lymphocyte ratio (NLR) were significantly associated with worse OS on univariate analyses. On multivariate analyses, poor PS (HR 8.7; 95%CI: 3.0–25.0; p <  0.001) and high NLR (HR 3.4; 95%CI: 1.3–8.8; p = 0.011) emerged as independent prognostic factors for OS. Conclusions SCUP is a rare presentation with an aggressive clinical course and limited survival. Diagnosis is difficult to make and requires careful review and synthesis of histology, immunohistochemistry, and molecular diagnostics. Chemotherapy resistance remains a challenge. Early mutational profiling is warranted, and clinical trial participation should be encouraged for this subset.

Outcome of trimodality-eligible esophagogastric cancer (EC) patients who declined surgery after preoperative chemoradiation.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 6-6 ◽  
Author(s):  
Takashi Taketa ◽  
Arlene M Correa ◽  
Akihiro Suzuki ◽  
Mariela Anabel Blum ◽  
Jeffrey Edwin Lee ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Performance Status ◽  
Preoperative Staging ◽  
Poor Performance ◽  
Complete Response ◽  
Endoscopic Biopsy ◽  
Preoperative Chemoradiation ◽  
Poor Performance Status ◽  
Trimodality Therapy ◽  
Esophagogastric Cancer

6 Background: Patients with localized EC eligible for resection at presentation should receive trimodality therapy (chemoradiation and surgery). However, surgical resection is not always performed in these patients because of poor performance status or reluctance in eligible patients to proceed with surgical resection after preoperative chemoradiation. Reports on the outcome of such patients are rare. Methods: Between 2002 and 2010, we identified 599 trimodality-eligible EC patients in our prospective database. All patients had extensive baseline staging, preoperative chemoradiation, and preoperative staging that included endoscopic biopsy and PET-CT. Of 599 patients, 32 patients declined surgery. Results: The median age was 70 years (range, 55-81), 29 patients (90.6%) were men and 30 (93.8%) were Caucasian. Majority had baseline stage II (44%) or III (38%) cancer. All 32 patients had an adenocarcinoma (moderate: 53.1%, poorly: 46.9%) and reached a clinical complete response (negative biopsy and PET in the physiologic range) post-chemoradiation. Four patients had salvage surgery and 3 are alive. Overall, 22 patients remain alive at a median follow up of 33.1 months (95% CI, 28.1-38.1). 3-year overall survival (OS) and relapse-free survival (RFS) were 65.1±10.4% and 37.5±10.3%. Median OS and RFS were 54.2 months (95% CI, 25.7-82.7), 30.4 months (95% CI, 16.3-44.5). Conclusions: Although the outcome of patients with EC who decline surgical resection after chemoradiation is reasonable, the lack of a validated approach to esophageal preservation dictates that trimodality therapy remains the standard of care in patients with potentially resectable EC.

Chromosome 1 abnormalities and clinical outcomes in multiple myeloma in the era of novel agents.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 8044-8044
Author(s):  
Smith Giri ◽  
Scott F. Huntington ◽  
Rong Wang ◽  
Amer Methqal Zeidan ◽  
Nikolai Alexandrovich Podoltsev ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Real World ◽  
Cox Regression ◽  
Performance Status ◽  
Poor Performance ◽  
Total Sample ◽  
Chromosome 1 ◽  
Poor Performance Status ◽  
Cox Regression Analysis ◽  
Entire Cohort

8044 Background: Abnormalities of chromosome 1 (C1A) are common genetic mutations in patients (pts) with Multiple Myeloma (MM). While several small studies have reported worse outcomes for C1A, the prevalence, real-world treatment and outcomes for pts with C1A are unknown. Methods: We used the Flatiron Health Electronic Health Record (EHR)-derived database to identify pts with newly diagnosed MM from 01/2011 to 03/2018 with Fluorescence In situ Hybridization (FISH) testing within 90 days of diagnosis and defined lines of therapy. We identified pts with C1A and other high-risk mutations (HRM; 17p deletion, t14;16 and t4;14). Pts were followed until 3/31/2018 or death. The primary outcome was overall survival (OS). We used Kaplan Meier methods and compared OS for pts with/without C1A using log-rank tests stratified for HRM. We used Cox regression analysis to compare OS across groups, adjusting for age, gender, performance status, stage, HRM and treatment (triple regimen vs other). Results: The total sample included 3,578 pts: median age at diagnosis was 69 yrs (IQR 31-85), with 54% males and 60% whites. IgG(57%) and IgA(22%) were the most common M-protein subtypes. At baseline, 844 (24%) had C1A. Pts with C1A had higher stage (ISS III 35% vs 26%; p < 0.01) and other HRM (27% vs 14%, p < 0.01). Common first line-therapies included bortezomib(V), lenalidomide(R) and dexamethasone (D) (35%), RD (20%) followed by VD(15%). Use of VRD was higher with C1A vs without (40% vs 33% respectively, p < 0.01). Median OS was 66.9 months for the entire cohort and was lower for pts with C1A vs without (median OS 46.6 vs 70.1 months; log rank p < 0.01). Multivariable Cox survival analysis showed that C1A was independently associated with worse OS (adjusted HR 1.64; 95% CI 1.23-2.19); p < 0.01). Other predictors of worse survival included older age, black ethnicity, higher ISS stage, poor performance status and HRM. Conclusions: In this large study of real-world practice, C1A was associated with inferior OS independent of other HRM, despite higher use of VRD. Future studies are needed to assess whether specific regimens improve outcomes for C1A compared to patients without HRM.

scholarly journals Importance of HER2 Work-Up and Treatment Even in Patients with Poor Performance Status: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Ali Suner ◽  
Hakan Buyukhatipoglu ◽  
Ozan Balakan ◽  
Mehmet Emin Kalender ◽  
Turgay Ulas ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Performance Status ◽  
Poor Performance ◽  
Complete Response ◽  
Metastatic Gastric Cancer ◽  
Poor Performance Status ◽  
Her2 Overexpression ◽  
First Line ◽  
Work Up

Gastric cancer is one of most common types of cancers. Metastatic gastric cancer has a poor prognosis and is accepted as incurable at this stage. Treatment of metastatic gastric cancer did not progress substantially until new targeted agents have come out. Recently published ToGA trial showed promising results in HER2 overexpressing metastatic gastric cancer. In this case we present a case with an excellent complete response with anti-HER2 treatment. Most importantly, we wanted to emphasize (1) the importance of early determination of HER2 overexpression, and (2) to draw attention of anti-HER2 agents in the first line treatment even in patients with a poor performance status.

scholarly journals Breast Metastasis of Gastric Signet Ring Cell Carcinoma: A Case Report and Literature Review

2021 ◽  
pp. 165-172
Author(s):  
Héctor Hugo Buerba-Vieregge ◽  
Ricardo Fernández-Ferreira ◽  
Pamela Denisse Soberanis-Piña ◽  
Ildefonso Roberto De la Peña-López ◽  
Lilian Mónica Navarro-García ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Carcinoma ◽  
Cell Carcinoma ◽  
Clinical History ◽  
Complete Response ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Breast Metastasis ◽  
Signet Ring ◽  
Ring Cell

Breast metastasis from gastric signet ring cell carcinoma is extremely rare in clinical practice. The estimated incidence is 0.5–1.3%. There are few cases reported in the literature (approx. less than 60) of breast metastasis from gastric signet ring cell carcinoma, and due to the rare association between gastric cancer and its extension to the breast, it is difficult to establish the diagnosis. Clinical history, histological findings, and immunohistochemical markers are helpful in distinguishing primary breast cancer from breast metastasis of gastric cancer. The treatment for breast metastasis from gastric carcinoma remains controversial. The prognosis of breast metastasis from gastric carcinoma is generally poor. We report a case of breast metastasis of gastric signet ring cell carcinoma in a 38-year-old woman. She started chemotherapy with ramucirumab, paclitaxel, and irinotecan. Three months later, a combined 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography showed a complete response. This is the first reported case of breast metastasis from gastric signet ring cell carcinoma with a complete response.

Gemcitabine plus nab-paclitaxel use in metastatic pancreatic cancer: A study of 40 patients.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 498-498
Author(s):  
Ivan Barrera ◽  
Sabin Dragos Filimon ◽  
Jassy Meng ◽  
Tomas Kavan ◽  
Young soo Rho ◽  
...  
Keyword(s):  
Performance Status ◽  
Real Life ◽  
Poor Performance ◽  
Poor Response ◽  
Complete Response ◽  
Primary Objective ◽  
Response To Treatment ◽  
Poor Performance Status ◽  
Dismal Prognosis ◽  
To Receive

498 Background: Metastatic pancreatic adenocarcinoma (mPDAC) carries a dismal prognosis, with often a poor response to treatment (Tx). Although gemcitabine with nab-paclitaxel (GnP) is now a standard 1st-line (1L) Tx in mPDAC, provincial policies limit its use. To understand the implications of the restriction, this real-life study was conducted. Methods: A historical prospective data was compiled using the local electronic medical record (Endovault Oncology v3.0, NY) at the Jewish General Hospital-McGill. All patients (pts) diagnosed with mPDAC that received GnP from 2013-2016 were identified. Demographics and Tx data was obtained. Primary objective was to evaluate tolerability in all lines of Tx [grade >2 CTCAE v4.03, mean Tx delay (mTxd)]. Secondary objectives were Tx attrition and outcomes [RECIST 1.1, complete response (CR), stable disease (SD) and progression disease (PD)]. Results: Of the 40 pts (female 60%, median age 64.3), 25 (62.5%) had primary at the head of the pancreas and 30 (75%) liver metastasis. 1L Tx: GnP 24 (60%), FOLFIRINOX 10 (FFX, 25%), Gemcitabine 5 (Gc, 12.5%) and FOLFOX 1 (2.5%). 70% of both FFX and Gc pts had grade 2 peripheral neuropathy (PN), neutropenia (NEUT) and fatigue. Half GnP pts had grade 2 NEUT and fatigue. mTxd in GnP, FFX and Gc were 7, 14 and 7 days. All FFX and Gc pts had PD. GnP cohort had 1 CR and 7 SD. 2L Tx was in 22 (55%): GnP 13 (59.5%), FFX 3 (13.5%), Capecitabine 2 (9%), FOLFOX 2 (9%) and Gc (9%). FFX pts 66.6% had grade 3 fatigue. GnP pts had grade 2 NEUT, PN and fatigue in 53.8%, 15.3% and 46.2%. mTxd were GnP 14 days and FFX 14 days. Except 1 SD, all FFX pts had PD. GnP pts had 1 CR, 6 SD, and 6 PD. All pts on Capecitabine, FOLFOX and Gc had PD. 3L Tx was in 6 (15%): 3 GnP (50%) and 3 on clinical trials (50%). All pts had PD and < 3 cycles. In 1L FFX pts, 7/10 and 3/6 went on to receive GnP in 2L and 3L. All 1L Gc pts had 2L GnP. Only 3 pts and 1 pt from 1L GnP pts went on to receive 2L and 3L Tx. Conclusions: Due to access limitations to GnP, its use was likely reserved for poor performance status pts. Instead, 1L FFX was used when possible. 1L FFX pts received more Tx lines due to initial pt selection. Further studies are needed in broader populations to evaluate optimal 1L Tx selection accounting for expected attrition and overall survival.

Outcomes of metastatic chromophobe renal cell carcinoma (ChRCC) with sarcomatoid features (SF).

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 678-678
Author(s):  
Yasser Ged ◽  
Andrea Knezevic ◽  
Yingbei Chen ◽  
Almedina Redzematovic ◽  
Maria Isabel Carlo ◽  
...  
Keyword(s):  
Clinical Features ◽  
Performance Status ◽  
Poor Performance ◽  
Cancer Center ◽  
Poor Performance Status ◽  
Newly Diagnosed ◽  
First Line ◽  
Entire Cohort ◽  
First Line Therapy ◽  
Line Therapy

678 Background: ChRCC makes up 5-10% of RCC subtypes and is generally thought to confer favorable prognosis. Presence of SF on histologic review can occur in any RCC subtype and is considered a hallmark of aggressive disease. We assessed outcomes in a cohort of patients (pts) with metastatic ChRCC and SF (sChRCC). Methods: Baseline clinical features and details on treatment were collected for pts with newly diagnosed metastatic sChRCC evaluated at Memorial Sloan Kettering Cancer Center (MSKCC) between 2002-17. Overall survival (OS) was calculated for all patients and time to treatment failure (TTF) for those who received first-line therapy at MSKCC. Next generation sequencing (NGS) with MSK-IMPACT was performed in a subset of pts. Results: 27 pts with newly diagnosed metastatic sChRCC were identified; other clinical features are summarized below ( table). 2 pts never received first line therapy based on poor performance status. 16 were treated at MSKCC and received a median of 2 lines of systemic therapy. First line agents included sunitinib (n = 6), pazopanib (n = 2), temsirolimus (n = 2), everolimus + bevacizumab (n = 2), sunitinib + gemcitabine (n = 2) and interferon alpha (n = 2) with median TTF of 2.1 months (0.9-14.5). Across the entire cohort (n = 27), median OS was 7.9 months (95% CI 4.2-11.2) with estimated 1 year OS rate of 25%. By comparison, a cohort of 67 pts with metastatic ChRCC lacking SF also treated at MSKCC 2002-17 achieved median OS of 38.1 months, (HR 4.6; 95% CI: 2.6-8.3; p < 0.001). In the 6 sChRCC pts with NGS analysis, TP53 (n = 4), PTEN (n = 2) and CHEK2 (n = 2) were the most frequently altered genes. Conclusions: Outcome for pts with metastatic sChRCC was poor in contrast to pts with ChRCC lacking SF. The lack of benefit observed across various classes of systemic agents warrants study of underlying biology and novel agents. [Table: see text]

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