First-line treatment of papillary renal cell carcinoma with sunitinib

Papillary renal cell carcinoma (PRCC) is a rare subtype of renal cell carcinoma (RCC), accounting for 10%-15% of all cases of RCC. There are two types of papillary RCC; type 1 and type 2. Currently, there is an unmet need for an effective first-line treatment for metastatic PRCC.

A recent phase 2 study, published in Annals of Oncology, the official journal of the European Society for Medical Oncology, in December 2019 evaluated sunitinib as a first-line treatment for mPRCC. There were 15 patients with type 1 and 46 patients with type 2 metastatic PRCC enrolled in the study and followed-up for a median of 51.4 months.

Around a third of patients with type 1 disease had stable disease for 12 weeks or longer, while nearly a quarter of patients with type 2 disease had stable disease for 12 weeks or more. Median progression-free survival was 6.6 months for type 1 and 5.5 months for type 2 patients, and median overall survival was 17.8 and 12.4 months, respectively. Side effects were as expected with sunitinib for metastatic RCC.

In conclusion, sunitinib was effective in patients with type 1 and type 2 metastatic PRCC, but not as effective as for patients with metastatic clear cell RCC. Survival outcomes were longer for patients with type I PRCC. Sunitinib is an acceptable option for the first-line treatment of metastatic PRCC.

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