CHEMOTHERAPY FOR SARCOMATOID RENAL CANCER

Med Oncol. 2010 Aug 18. [Epub ahead of print]
Long-term survival of patients with sarcomatoid renal cell cancer treated with chemotherapy.
Dutcher JP, Nanus D.

Oncology, New York Medical College, Montefiore, North Division, 600 East 233rd Street, Bronx, NY, 10466, USA, jpd4401@aol.com.
Abstract

Sarcomatoid renal cell cancer is associated with a very poor prognosis, characterized by rapid progression of advanced disease. We previously reported the outcome of 18 patients with advanced sarcomatoid renal cell cancer treated with a regimen consisting of doxorubicin, 50 mg/m(2) and gemcitabine, 1,500-2,000 mg/m(2), administered every two weeks with growth factor support (A/G). Among the 18 patients, there were two complete and 5 partial responses and two patients with stable disease of more than 6 months of duration. We now report long-term survival of 4 patients with stage IV sarcomatoid renal cell carcinoma treated with this regimen at the 1,500 mg/m(2) dose of gemcitabine, and achieving complete response (2 patients), or rendered complete responders following surgery after maximum response (2 patients). The two complete responders are alive, disease free at 6+ and 8+ years after starting A/G, and the 2 patients rendered CR by surgery survived 3(1/2) and 6 years, respectively. Both died of progressive disease, one with clear cell recurrence, one with sarcomatoid recurrence. In summary, this regimen is associated with a high response rate, overall improvement in progression free survival and occasional meaningful long-term survival in a disease expected to be fatal within one year.