Prognostic factors and current treatment strategies for renal cell carcinoma metastatic to the brain: An overview

Valeria Internò, Pierluigi De Santis, Luigia Stefania Stucci, Roberta Rudà, Marco Tucci, Riccardo Soffietti, Camillo Porta

Research output: Contribution to journalReview articlepeer-review

Abstract

Renal cell carcinoma (RCC) is one of primary cancers that frequently metastasize to the brain. Brain metastasis derived from RCC has the propensity of intratumoral hemorrhage and relatively massive surrounding edema. Moreover, it confers a grim prognosis in a great percentage of cases with a median overall survical (mOS) around 10 months. The well‐recognized prognostic factors for brain metastatic renal cell carcinoma (BMRCC) are Karnofsky Performance Status (KPS), the number of brain metastasis (BM), the presence of a sarcomatoid component and the presence of extracranial metastasis. Therapeutic strategies are multimodal and include surgical resection, radiotherapy, such as stereotactic radiosurgery due to the radioresistance of RCC and systemic strategies with tyrosin kinase inhibitors (TKI) or Immune checkpoint inhibitors (ICI) whose efficacy is not well‐established in this setting of patients due to their exclusion from most clinical trials. To date, in case of positive prognostic factors and after performing local radical therapies, such as complete resection of BM or stereotactic radiosurgery (SRS), the outcome of these patients significantly improves, up to 33 months in some patients. As a consequence, tailored clinical trials designed for BMRCC are needed to define the correct treatment strategy even in this poor prognostic subgroup of patients.

Original languageEnglish
Article number2114
JournalCancers
Volume13
Issue number9
DOIs
Publication statusPublished - May 1 2021

Keywords

  • Brain metastasis
  • Combined treatment
  • Cytoreductive nephrectomy
  • Immunotherapy
  • Prognostic factors
  • Radiation therapy
  • Renal cell carcinoma
  • Stereotactic radiosurgery
  • Target therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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