Sarcomatoid renal cell carcinoma (sRCC) is a rare and aggressive form of RCC in which the tumour cells look like the cells of a sarcoma (cancer of connective tissue such as muscles, nerves, fat, blood vessels etc.). Patients with metastatic RCC with sarcomatoid features are difficult to treat and do not respond well to targeted therapy, such as sunitinib and pazopanib. This study compares the outcomes for previously untreated patients with sarcomatoid RCC who were treated with a combination of cabozantinib plus nivolumab compared to sunitinib.
The researchers looked at 75 patients with sarcomatoid renal cell carcinoma from the phase 3 CheckMate 9ER study. The nivolumab plus cabozantinib combination was effective for sarcomatoid patients, reducing the risk of death by 64% compared to sunitinib. The time to when the treatment stopped working and the cancer started growing again (progression-free survival) was increased compared to sunitinib (10.3 months vs. 4.2 months) and the percentage of patients whose cancer got smaller or disappeared (response rate) was 56% for the combination compared to 22% for sunitinib.
With a median follow-up of two years, nivolumab plus cabozantinib continues to show improved cancer shrinkage (response rate), longer progression-free survival time, and longer overall survival time compared to sunitinib.