Multinational retrospective study of clinical features and response to immunotherapy combinations in metastatic renal cell carcinoma with sarcomatoid features

Metastatic renal cell carcinoma (mRCC) carrying sarcomatoid features (sRCC) has aggressive biology and poor prognosis. First-line immunotherapy (IO)-based combinations have improved outcomes of mRCC combinations, including that of sRCC. Real-world data confirmingthe adequate first-line management of sRCC is lacking. The multinational retrospective ARON-1 study included 1362 mRCC patients with IMDC intermediate or poor risk; 226 sRCC and 1136 non-sRCC. These two subgroups did not differ in terms of baseline characteristics. The median overall survival was 26.8 months in the sRCC subgroup versus 35.3 months in the non-sRCC subgroup (p=0.013). Within the sRCC subgroup, the median OS was 34.4 months with first-line IO plus tyrosine kinase inhibitor, and 26.4 months with first-line IO plus IO (p=0.729). The authors conclude that sRCC tumors are aggressive tumors with poor prognosis, and that first-line IO-based combinations improve survival outcomes of sRCC patients.