Prognostic significance of pancreatic metastases in patients with advanced renal cell carcinoma treated with systemic therapy

Abstract Background Pancreatic metastases (PM) are a rare site of metastasis for renal cell carcinoma (RCC). It has been suggested that patients with metastases to the pancreas have a more favorable prognosis, but little is known about the long-term outcomes of these patients with systemic therapy. Objective To understand the outcomes of patients with metastatic RCC with PM treated with systemic therapy. Design, Setting and Participants We conducted a pooled analysis of 4736 metastatic RCC patients treated on phase II and III clinical trials. Systemic therapies included anti-VEGF targeted therapy, mTOR-targeted therapy, and cytokine therapy. Outcome Measurements and Statistical Analysis The primary endpoint was overall survival in patients with PM versus those without PM. Statistical analyses were performed using Kaplan-Meier analysis and Cox regression. Results and Limitations Among 4736 patients, 235 patients (5.0%) were identified to have baseline PM at therapy initiation. Median OS in patients with PM was significantly prolonged with OS of 41.7 months vs 19.0 months (adjusted HR: 0.52, p Conclusions The presence of PM in RCC is an independent positive predictor for survival and improved response to systemic therapy. These findings suggest RCC with PM is associated with favorable outcomes and further work to understand the underlying disease biology of these patients is warranted.