Impact of MET status on treatment outcomes in papillary renal cell carcinoma: A pooled analysis of historical data.


Journal

European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373

Informations de publication

Date de publication:
07 2022
Historique:
received: 24 03 2022
accepted: 14 04 2022
pubmed: 1 6 2022
medline: 29 6 2022
entrez: 31 5 2022
Statut: ppublish

Résumé

Papillary renal cell carcinoma (PRCC) represents 15% of RCCs but has no indicated therapies, with limited biomarker-based data to inform targeted treatment. MET alterations may be key; > 80% of PRCC tumours show MET upregulation. The objective of this study was to assess MET status in PRCC and its impact on clinical outcomes. This retrospective, observational study included patients with locally advanced/metastatic PRCC from three international registries. MET status was determined retrospectively by next generation sequencing (NGS) of archival tissue. MET-driven was defined as MET and/or hepatocyte growth factor amplification, chromosome 7 gain, and/or MET kinase domain mutations. Objectives included progression-free survival (PFS) and overall survival (OS) by MET status using a Cox proportional hazards model. Of 308 patients, 305 received first-line treatment; most commonly sunitinib (n = 208; 68%), then everolimus (n = 40; 13%). Of 179 patients with valid NGS results, 38% had MET-driven and 49% MET-independent tumours (13% unevaluable). In the MET-driven versus MET-independent subgroups, respectively, of sunitinib-treated patients, median PFS was numerically longer, though not statistically significantly; PFS: 9.2 months (95% confidence interval [CI]: 5.4-13.2) versus 5.7 months (95% CI: 4.3-7.4), hazard ratio (HR) = 0.67; 95% CI: 0.41-1.08. There was no difference between the OS of each subgroup. MET-driven PRCC may respond to targeted agents. However, the presence of MET alterations did not appear to be predictive for outcomes in response to current therapies, which are not biomarker-driven, compared with MET-independent tumours.

Sections du résumé

BACKGROUND
Papillary renal cell carcinoma (PRCC) represents 15% of RCCs but has no indicated therapies, with limited biomarker-based data to inform targeted treatment. MET alterations may be key; > 80% of PRCC tumours show MET upregulation. The objective of this study was to assess MET status in PRCC and its impact on clinical outcomes.
METHODS
This retrospective, observational study included patients with locally advanced/metastatic PRCC from three international registries. MET status was determined retrospectively by next generation sequencing (NGS) of archival tissue. MET-driven was defined as MET and/or hepatocyte growth factor amplification, chromosome 7 gain, and/or MET kinase domain mutations. Objectives included progression-free survival (PFS) and overall survival (OS) by MET status using a Cox proportional hazards model.
RESULTS
Of 308 patients, 305 received first-line treatment; most commonly sunitinib (n = 208; 68%), then everolimus (n = 40; 13%). Of 179 patients with valid NGS results, 38% had MET-driven and 49% MET-independent tumours (13% unevaluable). In the MET-driven versus MET-independent subgroups, respectively, of sunitinib-treated patients, median PFS was numerically longer, though not statistically significantly; PFS: 9.2 months (95% confidence interval [CI]: 5.4-13.2) versus 5.7 months (95% CI: 4.3-7.4), hazard ratio (HR) = 0.67; 95% CI: 0.41-1.08. There was no difference between the OS of each subgroup.
CONCLUSIONS
MET-driven PRCC may respond to targeted agents. However, the presence of MET alterations did not appear to be predictive for outcomes in response to current therapies, which are not biomarker-driven, compared with MET-independent tumours.

Identifiants

pubmed: 35640484
pii: S0959-8049(22)00231-3
doi: 10.1016/j.ejca.2022.04.021
pii:
doi:

Substances chimiques

Sunitinib V99T50803M

Types de publication

Journal Article Meta-Analysis Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

158-168

Informations de copyright

Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

Laurence Albiges (L)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Cancer Medicine, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France. Electronic address: laurence.albiges@gustaveroussy.fr.

Daniel Y C Heng (DYC)

Department of Medical Oncology, Tom Baker Cancer Center, University of Calgary, Calgary, Alberta, Canada. Electronic address: Daniel.Heng@albertahealthservices.ca.

Jae Lyun Lee (JL)

Department of Oncology, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea. Electronic address: jaelyun@amc.seoul.kr.

Stephen Walker (S)

Syneos Health, Charlotte, NC, USA. Electronic address: stephen.walker@syneoshealth.com.

Anders Mellemgaard (A)

Oncology R&D, AstraZeneca, Cambridge, UK. Electronic address: anders.mellemgaard@astrazeneca.com.

Lone Ottesen (L)

Targovax Asa, Oslo, Norway. Electronic address: Loneott@dadlnet.dk.

Melanie M Frigault (MM)

Vincerx Pharma, Inc., Palo Alto, CA, USA. Electronic address: melanie.frigault@gmail.com.

Anne L'Hernault (A)

Precision Medicine and Biosamples, Oncology R&D, AstraZeneca, Cambridge, UK. Electronic address: anne.lhernault@astrazeneca.com.

Jonathan Wessen (J)

Oncology R&D, AstraZeneca, Cambridge, UK. Electronic address: jonathan.wessen@astrazeneca.com.

Toni Choueiri (T)

Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA. Electronic address: Toni_Choueiri@DFCI.HARVARD.EDU.

Mathilde Cancel (M)

Department of Medical Oncology, CHU Bretonneau Centre, University of Tours, Tours, France. Electronic address: cancel@univ-tours.fr.

Sabina Signoretti (S)

Harvard Medical School, Boston, MA, USA; Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: ssignoretti@bwh.harvard.edu.

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Classifications MeSH