1,689 people with metastatic renal cell carcinoma (RCC) had MRI brain scans for entry into clinical trials. Of these, 4% had brain metastases that did not show any symptoms. These patients had a low average survival (10.3 months). 86% also had spread to other organs, including the lungs, liver and bone.
Brain scans are routine for patients with symptoms that suggest metastases in the brain or spinal cord. However, none of these patients had these symptoms and would have been missed if they were not considering a clinical trial.
Dr Jonasch, Vice-Chair of the NCCN Clinical Practice Guidelines in Oncology Panel for Kidney Cancer, said: “The findings in this study are important for two reasons. First, they show that the overall prognosis of patients with brain metastases is consistently worse than the broader population of patients with metastatic renal cell carcinoma. We need to develop a deeper scientific understanding of why this patient population has a worse outcome, and we need to include them in future clinical trials. Second, they underscore the utility for MRI imaging of all patients with metastatic renal cell carcinoma both at initial diagnosis, and at regular intervals, to detect occult brain metastases, since specific treatment strategies are required for this patient population.”
Further studies are needed to determine how frequently patients should be scanned for brain metastases.