Skip to main content

Treatment for Non-clear Cell Renal Cell Carcinoma

  • Chapter
  • First Online:
  • 1018 Accesses

Abstract

Non-clear cell (NCC) renal cell carcinoma (RCC) is less common and accounts for 25 % of all patients with metastatic RCC. Metastatic NCCRCC and clear cell (CC) RCC both respond infrequently to cytotoxic and cytokine therapy; however, compared with CCRCC patients, NCCRCC patients have a poorer prognosis. Tyrosine kinase inhibitors (TKIs) such as sorafenib and sunitinib have significant activity in metastatic NCCRCC, but the efficacy of each agent seems to vary between different NCCRCC forms. Preliminary clinical data for temsirolimus, one of the mammalian targets of rapamycin (mTOR) inhibitors, appear to be promising, but future phase III trials should include patients with RCCs with NCC histology as well as CCRCC, with appropriate stratification to take the balance between each treatment arm. Many ongoing phase II trials should provide interesting preliminary insights into the antitumor efficacy of particular agents in these tumors. These approaches will lead us to improvements in the management of NCCRCC so as we have already achieved with the more common CCRCC.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Lopez-Beltran A, Carrasco JC, Cheng L, Scarpelli M, Kirkali Z, Montironi R (2009) 2009 update on the classification of renal epithelial tumors in adults. Int J Urol Off J Japanese Urol Assoc 16(5):432–443. doi:10.1111/j.1442-2042.2009.02302.x

    Google Scholar 

  2. Schrader AJ, Varga Z, Pfoertner S, Goelden U, Buer J, Hofmann R (2006) Treatment targeted at vascular endothelial growth factor: a promising approach to managing metastatic kidney cancer. BJU Int 97(3):461–465

    Article  CAS  PubMed  Google Scholar 

  3. Motzer RJ, Bacik J, Mariani T, Russo P, Mazumdar M, Reuter V (2002) Treatment outcome and survival associated with metastatic renal cell carcinoma of non-clear-cell histology. J Clin Oncol Off J Am Soc Clin Oncol 20(9):2376–2381

    Article  Google Scholar 

  4. Yang XJ, Tan MH, Kim HL, Ditlev JA, Betten MW, Png CE, Kort EJ, Futami K, Furge KA, Takahashi M, Kanayama HO, Tan PH, Teh BS, Luan C, Wang K, Pins M, Tretiakova M, Anema J, Kahnoski R, Nicol T, Stadler W, Vogelzang NG, Amato R, Seligson D, Figlin R, Belldegrun A, Rogers CG, Teh BT (2005) A molecular classification of papillary renal cell carcinoma. Cancer Res 65(13):5628–5637

    Article  CAS  PubMed  Google Scholar 

  5. Ratain MJ, Eisen T, Stadler WM, Flaherty KT, Kaye SB, Rosner GL, Gore M, Desai AA, Patnaik A, Xiong HQ, Rowinsky E, Abbruzzese JL, Xia C, Simantov R, Schwartz B, O’Dwyer PJ (2006) Phase II placebo-controlled randomized discontinuation trial of sorafenib in patients with metastatic renal cell carcinoma. J Clin Oncol Off J Am Soc Clin Oncol 24(16):2505–2512

    Article  CAS  Google Scholar 

  6. Stadler WM, Figlin RA, McDermott DF, Dutcher JP, Knox JJ, Miller WH Jr, Hainsworth JD, Henderson CA, George JR, Hajdenberg J, Kindwall-Keller TL, Ernstoff MS, Drabkin HA, Curti BD, Chu L, Ryan CW, Hotte SJ, Xia C, Cupit L, Bukowski RM, Investigators AS (2010) Safety and efficacy results of the advanced renal cell carcinoma sorafenib expanded access program in North America. Cancer 116(5):1272–1280. doi:10.1002/cncr.24864

    Article  CAS  PubMed  Google Scholar 

  7. Beck J, Procopio G, Bajetta E, Keilholz U, Negrier S, Szczylik C, Bokemeyer C, Bracarda S, Richel DJ, Staehler M, Strauss UP, Mersmann S, Burock K, Escudier B (2011) Final results of the European Advanced Renal Cell Carcinoma Sorafenib (EU-ARCCS) expanded-access study: a large open-label study in diverse community settings. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO 22(8):1812–1823. doi:10.1093/annonc/mdq651

    Article  CAS  Google Scholar 

  8. Plantade A, Choueiri TK, Escudier B (2007) Treatment outcome for metastatic papillary and chromophobe renal cell carcinoma (RCC) patients treated with tyrosine-kinase inhibitors (TKIs) sunitinib and sorafenib. J Clin Oncol Off J Am Soc Clin Oncol 25: Abstract 5037

    Google Scholar 

  9. Gore ME, Porta C, Oudard S (2007) Sunitinib in metastatic renal cell carcinoma (mRCC). Preliminary assessment of toxicity in an expanded access trial with subpopulation analysis. J Clin Oncol Off J Am Soc Clin Oncol 25: Abstract 5010

    Google Scholar 

  10. Gore ME, Szczylik C, Porta C, Bracarda S, Bjarnason GA, Oudard S, Hariharan S, Lee SH, Haanen J, Castellano D, Vrdoljak E, Schoffski P, Mainwaring P, Nieto A, Yuan J, Bukowski R (2009) Safety and efficacy of sunitinib for metastatic renal-cell carcinoma: an expanded-access trial. Lancet Oncol 10(8):757–763. doi:10.1016/S1470-2045(09)70162-7

    Article  CAS  PubMed  Google Scholar 

  11. Choueiri TK, Plantade A, Elson P, Negrier S, Ravaud A, Oudard S, Zhou M, Rini BI, Bukowski RM, Escudier B (2008) Efficacy of sunitinib and sorafenib in metastatic papillary and chromophobe renal cell carcinoma. J Clin Oncol Off J Am Soc Clin Oncol 26(1):127–131

    Article  CAS  Google Scholar 

  12. Molina AM, Feldman DR, Ginsberg MS, Kroog G, Tickoo SK, Jia X, Georges M, Patil S, Baum MS, Reuter VE, Motzer RJ (2012) Phase II trial of sunitinib in patients with metastatic non-clear cell renal cell carcinoma. Investig New Drugs 30(1):335–340. doi:10.1007/s10637-010-9491-6

    Article  CAS  Google Scholar 

  13. Lee JL, Ahn JH, Lim HY, Park SH, Lee SH, Kim TM, Lee DH, Cho YM, Song C, Hong JH, Kim CS, Ahn H (2012) Multicenter phase II study of sunitinib in patients with non-clear cell renal cell carcinoma. Ann Oncol Off J Eur Soc Med Oncol ESMO 23(8):2108–2114. doi:10.1093/annonc/mdr586

    Article  Google Scholar 

  14. Hudes G, Carducci M, Tomczak P, Dutcher J, Figlin R, Kapoor A, Staroslawska E, Sosman J, McDermott D, Bodrogi I, Kovacevic Z, Lesovoy V, Schmidt-Wolf IG, Barbarash O, Gokmen E, O’Toole T, Lustgarten S, Moore L, Motzer RJ, Global AT (2007) Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma. N Engl J Med 356(22):2271–2281. doi:10.1056/NEJMoa066838

    Article  CAS  PubMed  Google Scholar 

  15. Dutcher JP, Szczylik C, Tannir N (2007) Correlation of survival with tumor histology, age, and prognostic risk group for previously untreated patients with advanced renal cell carcinoma (adv RCC) receiving temsirolimus (TEMSR) or interferonalpha (IFN). J Clin Oncol Off J Am Soc Clin Oncol 25: Abstract 5033

    Google Scholar 

  16. Dutcher JP, de Souza P, McDermott D, Figlin RA, Berkenblit A, Thiele A, Krygowski M, Strahs A, Feingold J, Hudes G (2009) Effect of temsirolimus versus interferon-alpha on outcome of patients with advanced renal cell carcinoma of different tumor histologies. Med Oncol 26(2):202–209

    Article  CAS  PubMed  Google Scholar 

  17. Yang S, de Souza P, Alemao E, Purvis J (2010) Quality of life in patients with advanced renal cell carcinoma treated with temsirolimus or interferon-alpha. Br J Cancer 102(10):1456–1460. doi:10.1038/sj.bjc.6605647

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Blank CU BP, Larkin JMG et al (2012) Safety and efficacy of everolimus in patients with non-clear cell renal cell carcinoma refractory to VEGF-targeted therapy: subgroup analysis of REACT. J Clin Oncol 30 (suppl 5) (abstr 402)

    Google Scholar 

  19. Schmidt L, Duh FM, Chen F, Kishida T, Glenn G, Choyke P, Scherer SW, Zhuang Z, Lubensky I, Dean M, Allikmets R, Chidambaram A, Bergerheim UR, Feltis JT, Casadevall C, Zamarron A, Bernues M, Richard S, Lips CJ, Walther MM, Tsui LC, Geil L, Orcutt ML, Stackhouse T, Lipan J, Slife L, Brauch H, Decker J, Niehans G, Hughson MD, Moch H, Storkel S, Lerman MI, Linehan WM, Zbar B (1997) Germline and somatic mutations in the tyrosine kinase domain of the MET proto-oncogene in papillary renal carcinomas. Nat Genet 16(1):68–73

    Article  CAS  PubMed  Google Scholar 

  20. Sweeney P, El-Naggar AK, Lin SH, Pisters LL (2002) Biological significance of c-met over expression in papillary renal cell carcinoma. J Urol 168(1):51–55

    Article  CAS  PubMed  Google Scholar 

  21. Eder JP, Shapiro GI, Appleman LJ, Zhu AX, Miles D, Keer H, Cancilla B, Chu F, Hitchcock-Bryan S, Sherman L, McCallum S, Heath EI, Boerner SA, LoRusso PM (2010) A phase I study of foretinib, a multi-targeted inhibitor of c-Met and vascular endothelial growth factor receptor 2. Clin Cancer Res Off J Am Assoc Cancer Res 16(13):3507–3516. doi:10.1158/1078-0432.CCR-10-0574

    Article  CAS  Google Scholar 

  22. Choueiri TK, Vaishampayan U, Rosenberg JE, Logan TF, Harzstark AL, Bukowski RM, Rini BI, Srinivas S, Stein MN, Adams LM, Ottesen LH, Laubscher KH, Sherman L, McDermott DF, Haas NB, Flaherty KT, Ross R, Eisenberg P, Meltzer PS, Merino MJ, Bottaro DP, Linehan WM, Srinivasan R (2013) Phase II and biomarker study of the dual MET/VEGFR2 inhibitor foretinib in patients with papillary renal cell carcinoma. J Clin Oncol Off J Am Soc Clin Oncol 31(2):181–186. doi:10.1200/JCO.2012.43.3383

    Article  CAS  Google Scholar 

  23. Asakuma J, Sumitomo M, Asano T, Hayakawa M (2004) Modulation of tumor growth and tumor induced angiogenesis after epidermal growth factor receptor inhibition by ZD1839 in renal cell carcinoma. J Urol 171(2 Pt 1):897–902

    Article  CAS  PubMed  Google Scholar 

  24. Sumitomo M, Asano T, Asakuma J, Horiguchi A, Hayakawa M (2004) ZD1839 modulates paclitaxel response in renal cancer by blocking paclitaxel-induced activation of the epidermal growth factor receptor-extracellular signal-regulated kinase pathway. Clin Cancer Res 10(2):794–801

    Article  CAS  PubMed  Google Scholar 

  25. Gordon MS, Hussey M, Nagle RB, Lara PN Jr, Mack PC, Dutcher J, Samlowski W, Clark JI, Quinn DI, Pan CX, Crawford D (2009) Phase II study of erlotinib in patients with locally advanced or metastatic papillary histology renal cell cancer: SWOG S0317. J Clin Oncol Off J Am Soc Clin Oncol 27(34):5788–5793

    Article  CAS  Google Scholar 

  26. Stadler WM, Figlin RA, Ernstoff MS (2007) The Advanced Renal Cell Carcinoma Sorafenib (ARCCS) expanded access trial. Safety and efficacy in patients (pts) with non-clear cell (NCC) renal cell carcinoma (RCC). J Clin Oncol Off J Am Soc Clin Oncol 25: Abstract 5036

    Google Scholar 

  27. Vuky J, Isacson C, Fotoohi M, dela Cruz J, Otero H, Picozzi V, Malpass T, Aboulafia D, Jacobs A (2006) Phase II trial of imatinib (Gleevec) in patients with metastatic renal cell carcinoma. Investig New Drugs 24(1):85–88

    Article  CAS  Google Scholar 

  28. Oudard S, Banu E, Vieillefond A, Fournier L, Priou F, Medioni J, Banu A, Duclos B, Rolland F, Escudier B, Arakelyan N, Culine S (2007) Prospective multicenter phase II study of gemcitabine plus platinum salt for metastatic collecting duct carcinoma: results of a GETUG (Groupe d’Etudes des Tumeurs Uro-Genitales) study. J Urol 177(5):1698–1702

    Article  CAS  PubMed  Google Scholar 

  29. Parikh J, Coleman T, Messias N, Brown J (2009) Temsirolimus in the treatment of renal cell carcinoma associated with Xp11.2 translocation/TFE gene fusion proteins: a case report and review of literature. Rare Tumors 1(2):e53. doi:10.4081/rt.2009.e53

    PubMed  PubMed Central  Google Scholar 

  30. Choueiri TK, Mosquera JM, Hirsch MS (2009) A case of adult metastatic Xp11 translocation renal cell carcinoma treated successfully with sunitinib. Clin Genitourin Cancer 7(3):E93–E94. doi:10.3816/CGC.2009.n.031

    Article  PubMed  Google Scholar 

  31. Numakura K, Tsuchiya N, Yuasa T, Saito M, Obara T, Tsuruta H, Narita S, Horikawa Y, Satoh S, Habuchi T (2011) A case study of metastatic Xp11.2 translocation renal cell carcinoma effectively treated with sunitinib. Int J Clin Oncol 16(5):577–580. doi:10.1007/s10147-010-0154-6

    Article  PubMed  Google Scholar 

  32. Choueiri TK, Lim ZD, Hirsch MS, Tamboli P, Jonasch E, McDermott DF, Dal Cin P, Corn P, Vaishampayan U, Heng DY, Tannir NM (2010) Vascular endothelial growth factor-targeted therapy for the treatment of adult metastatic Xp11.2 translocation renal cell carcinoma. Cancer 116(22):5219–5225. doi:10.1002/cncr.25512

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Malouf GG, Camparo P, Oudard S, Schleiermacher G, Theodore C, Rustine A, Dutcher J, Billemont B, Rixe O, Bompas E, Guillot A, Boccon-Gibod L, Couturier J, Molinie V, Escudier B (2010) Targeted agents in metastatic Xp11 translocation/TFE3 gene fusion renal cell carcinoma (RCC): a report from the Juvenile RCC Network. Ann Oncol Off J Eur Soc Med Oncol ESMO 21(9):1834–1838. doi:10.1093/annonc/mdq029

    Article  CAS  Google Scholar 

  34. Mian BM, Bhadkamkar N, Slaton JW, Pisters PW, Daliani D, Swanson DA, Pisters LL (2002) Prognostic factors and survival of patients with sarcomatoid renal cell carcinoma. J Urol 167(1):65–70

    Article  PubMed  Google Scholar 

  35. Nanus DM, Garino A, Milowsky MI, Larkin M, Dutcher JP (2004) Active chemotherapy for sarcomatoid and rapidly progressing renal cell carcinoma. Cancer 101(7):1545–1551

    Article  CAS  PubMed  Google Scholar 

  36. Beck J, Bajetta E, Escudier B (2007) A large open-label, non-comparative, phase III study of the multi-targeted kinase inhibitor Sorafenib in European patients with advanced renal cell carcinoma. Eur J Cancer Suppl 5: 300 Abstract 4506

    Google Scholar 

  37. Golshayan AR, George S, Heng DY, Elson P, Wood LS, Mekhail TM, Garcia JA, Aydin H, Zhou M, Bukowski RM, Rini BI (2009) Metastatic sarcomatoid renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy. J Clin Oncol Off J Am Soc Clin Oncol 27(2):235–241

    Article  Google Scholar 

  38. Dutcher JP, Nanus D (2011) Long-term survival of patients with sarcomatoid renal cell cancer treated with chemotherapy. Med Oncol 28(4):1530–1533. doi:10.1007/s12032-010-9649-2

    Article  CAS  PubMed  Google Scholar 

  39. Haas NB, Lin X, Manola J, Pins M, Liu G, McDermott D, Nanus D, Heath E, Wilding G, Dutcher J (2012) A phase II trial of doxorubicin and gemcitabine in renal cell carcinoma with sarcomatoid features: ECOG 8802. Med Oncol 29(2):761–767. doi:10.1007/s12032-011-9829-8

    Article  CAS  PubMed  Google Scholar 

  40. Escudier B, Eisen T, Porta C, Patard JJ, Khoo V, Algaba F, Mulders P, Kataja V, Group EGW (2012) Renal cell carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol Off J Eur Soc Med Oncol ESMO 23(Suppl 7):vii65–vii71. doi:10.1093/annonc/mds227

    Article  Google Scholar 

  41. NCCN (2012) Clinical practice guidelines in oncology. Kidney Cancer. Version 2. http://www.nccn.org/professionals/physician_gls/pdf/kidney.pdf. Accessed Jan 2013

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Makoto Sumitomo M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer Japan KK

About this chapter

Cite this chapter

Sumitomo, M. (2017). Treatment for Non-clear Cell Renal Cell Carcinoma. In: Oya, M. (eds) Renal Cell Carcinoma. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55531-5_13

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-55531-5_13

  • Published:

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-55530-8

  • Online ISBN: 978-4-431-55531-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics