Occult Brain Mets Detected in Patients With Advanced Renal Cancer

MONDAY, May 2, 2021 — Recent study by researchers of Memorial Sloan Kettering Cancer Center highlights that 4% to 5% of patients with metastatic renal cell carcinoma (mRCC) may harbor metastatic occult brain disease. This study results were published in the JNCCN, . The results published in Journal of the National Comprehensive Cancer Network were derived from data of 1,689 patients with mRCC from 68 clinical trials conducted between 2001 and 2019 with a median 14.1-month follow-up.

Ritesh R. Kotecha, M.D., from the Memorial Sloan Kettering Cancer Center and colleagues retrospectively reviewed data from patients with mRCC incidentally diagnosed with asymptomatic brain metastases during screening for clinical trial participation.

The researchers found that 4.3 percent of patients with mRCC harbored occult brain metastases. A majority of the 72 patients in this cohort (86 percent) had two or more extracranial sites of disease, including lung metastases (92 percent). International Metastatic RCC Database Consortium (IMDC) risk status was favorable for 26 percent, intermediate for 61 percent, and poor for 13 percent of these patients. In more than one-third of patients (38.5 percent), central nervous system involvement was multifocal, and the largest brain metastasis was >1 cm in diameter in 40 percent of the cohort. In almost all patients (93 percent), localized brain-directed therapy (predominantly radiotherapy) was pursued. Median overall survival was 10.3 months, while the one-year overall survival probability was 48 percent. There was no association noted between IMDC risk and number or size of lesions and survival.

“These data provide rationale for brain screening in patients with advanced RCC,” the authors write.  In particular, Screening should be considered for patients with high metastatic burden or those who have experienced disease progression after first-line therapies. 

Several authors disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text

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