Impact of initial treatment strategy for metastatic renal cell cancer on development of brain metastasis

A diagnosis of brain metastasis (BM) significantly affects quality of life in patients with metastatic renal cell cancer (mRCC). In clinical practice, active surveillance (AS) is commonly used as initial approach for mRCC. A retrospective cohort study at Erasmus University Cancer Center (Rotterdam, The Netherlands) included mRCC patients with metachronous BM (diagnosed at least one month after diagnosis of extracranial metastasis; ECM). The median BM-free survival since ECM diagnosis was significantly longer among patients who received previous systemic treatment for ECM compared to treatment naïve patients (29.0 versus 6.8 months; p=0.02). The authors conclude that these results emphasize the need for careful evaluation of treatment strategies, and especially AS, for patients with mRCC (visual abstract).