Single-center phase 2 trial of metastasis-directed radiotherapy without systemic therapy for oligometastatic clear-cell renal cell carcinoma

A phase 2 trial at MD Anderson Cancer Center (Houston, TX) evaluated metastasis-directed therapy without systemic therapy for patient with oligometastatic (up to 5 metastases) clear-cell renal cell carcinoma. Patients received radiotherapy to all disease sites, with additional metastasis-directed therapy for limited progression. The median progression-free survival was 17.7 months, and the median systemic therapy-free survival was 34.0 months. Six percent of patients had grade 3 adverse events, one patient had grade 4 hyperglycemia, and there were no grade 5 AEs. The authors conclude that select patients with oligometastatic ccRCC can be managed with serial metastasis-directed therapy with prolonged time off out systemic therapy, favorable PFS, and limited adverse events.