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Papillary Renal Cell Carcinoma: A Review of Prospective Clinical Trials

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Opinion statement

PRCC is a unique histologic entity compared to other forms of renal cell carcinoma, harboring distinct molecular drivers. The WHO 2022 classification is further emphasizing the molecular biology by making molecular classifications of PRCC subclassifications and discontinuing the morphologic type 1 and type 2 classification system. We agree with this functional classification system and encourage all future clinical trials to only include patients with similar diagnosis instead of conducting basket trials (including all nccRCC together) which limits the scientific value of those conclusions. Based on recent disease-specific clinical trial (S1500, PAPMET), the current standard of care for patients with treatment naïve PRCC is cabozantinib. Prospective clinical trials clearly establish that immune checkpoint inhibitor therapy has meaningful activity in PRCC. The data to date include only single-arm clinical trials of combination immune therapy. Despite the positive and encouraging results, we need validation through randomized studies because of the overestimation of effect size seen in single-arm trials. These randomized trials are currently underway and enrolling. We strongly encourage all physicians to support these studies and enroll patients with PRCC to these trials in order to continue improving the standard of care.

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Authors and Affiliations

  1. Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA

    Benjamin L. Maughan MD, PharmD

  2. University of Utah School of Medicine, Salt Lake City, UT, USA

    Deepika Sirohi MD

  3. Molecular Oncology, ARUP Laboratories, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA

    Deepika Sirohi MD

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Correspondence to Benjamin L. Maughan MD, PharmD.

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B.L.M. is a paid consultant/advisor to Abbvie, Pfizer, AVEO oncology, Janssen, Astellas, Bristol-Myers Squibb, Clovis, Tempus, Merck, Exelixis, Bayer Oncology, Lilly, and Peloton Therapeutics; Huntsman Cancer Institute has received research funding from Exelixis (Inst), Bavarian-Nordic (Inst), Clovis (Inst), Genentech (Inst), and Bristol-Myers Squibb (Inst) on his behalf. I have received financial compensation as a paid consultant/advisor to Abbvie, Pfizer, AVEO oncology, Janssen, Astellas, Bristol-Myers Squibb, Clovis, Tempus, Merck, Exelixis, Bayer Oncology, Lilly, and Peloton Therapeutics; Huntsman Cancer Institute has received research funding from Exelixis, Bavarian-Nordic, Clovis, and Bristol-Myers Squibb on my behalf.

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Maughan, B.L., Sirohi, D. Papillary Renal Cell Carcinoma: A Review of Prospective Clinical Trials. Curr. Treat. Options in Oncol. 24, 1199–1212 (2023). https://doi.org/10.1007/s11864-023-01107-x

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