{"doi":"10.1016/j.clgc.2023.09.004","title":"Outcomes of Patients With Advanced Renal Cell Carcinoma With Non-Clear Cell Histology Treated With Systemic Therapy","abstract":"•We demonstrate inferior overall survival in patients with advanced non-clear cell RCC compared to clear cell RCC treated with systemic therapy.•Despite advancements in treatment options, patients with sarcomatoid RCC continue to have inferior survival compared to patients without sarcomatoid RCC.•Additionally time to first treatment failure was shorter in patients with non-clear cell RCC compared to clear cell RCC treated with systemic therapy. BackgroundPatients with non-clear cell renal cell carcinoma (RCC) and RCC with sarcomatoid differentiation have been under-represented in clinical trials. This study evaluates the outcomes and treatment patterns of patients with non-clear cell RCC and RCC with sarcomatoid features compared to those with clear cell RCC receiving systemic therapy.MethodsA single center retrospective analysis of patients with advanced or metastatic RCC receiving systemic therapy was conducted. Patients were divided into groups based on histology: non-clear cell RCC, clear cell RCC, and RCC with and without sarcomatoid features. The primary endpoint was overall survival (OS) for each group calculated from the date of diagnosis of advanced or metastatic RCC to date of last follow-up or death. Additionally, an exploratory analysis was conducted by non-clear cell type and type of first-line treatment.ResultsOverall, 251 patients were included, with most treated before 2018. First-line therapies included VEGF monotherapy (68.5%), immunotherapy monotherapy (7.6%), immunotherapy combination therapy (16.7%), or other treatments (7.2%). Overall survival was shorter for patients with non-clear cell RCC compared to clear cell RCC (39.2 months versus 81.1 months, hazard ratio (HR), 1.60, 95% Confidence Interval 1.0, 2.6, p=0.04). Additionally, OS for patients with sarcomatoid differentiation was shorter compared to patients without sarcomatoid differentiation (43.4 versus 75.0 months, HR 1.5, 95% CI 0.8, 2.6, p=0.20).ConclusionWe demonstrate inferior outcomes among patients with advanced or metastatic non-clear cell RCC and RCC with sarcomatoid differentiation receiving systemic treatment. Further prospective studies are warranted testing immunotherapy combinations and novel treatments in patients with non-clear cell RCC.MicroAbstractThis study evaluated the outcomes of patients with non-clear cell RCC and RCC with sarcomatoid features receiving systemic treatment. We conducted a single center retrospective analysis of 251 patients with advanced RCC receiving systemic therapy. Overall, patients with non-clear cell histology and RCC with sarcomatoid features had worse overall survival compared to those with clear cell histology. Patients with non-clear cell renal cell carcinoma (RCC) and RCC with sarcomatoid differentiation have been under-represented in clinical trials. This study evaluates the outcomes and treatment patterns of patients with non-clear cell RCC and RCC with sarcomatoid features compared to those with clear cell RCC receiving systemic therapy. A single center retrospective analysis of patients with advanced or metastatic RCC receiving systemic therapy was conducted. Patients were divided into groups based on histology: non-clear cell RCC, clear cell RCC, and RCC with and without sarcomatoid features. The primary endpoint was overall survival (OS) for each group calculated from the date of diagnosis of advanced or metastatic RCC to date of last follow-up or death. Additionally, an exploratory analysis was conducted by non-clear cell type and type of first-line treatment. Overall, 251 patients were included, with most treated before 2018. First-line therapies included VEGF monotherapy (68.5%), immunotherapy monotherapy (7.6%), immunotherapy combination therapy (16.7%), or other treatments (7.2%). Overall survival was shorter for patients with non-clear cell RCC compared to clear cell RCC (39.2 months versus 81.1 months, hazard ratio (HR), 1.60, 95% Confidence Interval 1.0, 2.6, p=0.04). Additionally, OS","journal":"Clinical Genitourinary Cancer","year":2023,"id":362893,"datarank":0.32958368660043297,"base_score":2.1972245773362196,"endowment":2.1972245773362196,"self_citation_contribution":0.32958368660043297,"citation_network_contribution":0.0,"self_endowment_contribution":0.32958368660043297,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.954,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1116915,"name":"Leah Deshler","orcid":null,"position":1,"is_corresponding":false},{"id":897024,"name":"Nicole Weise","orcid":"0000-0002-8824-3212","position":2,"is_corresponding":false},{"id":993570,"name":"Ahmed Shabaik","orcid":"0000-0003-1987-3453","position":3,"is_corresponding":false},{"id":489974,"name":"Ithaar Derweesh","orcid":"0000-0002-8673-0711","position":4,"is_corresponding":false},{"id":345891,"name":"Aditya Bagrodia","orcid":"0000-0002-3358-1193","position":5,"is_corresponding":false},{"id":263871,"name":"Brent S. Rose","orcid":"0000-0002-3197-9552","position":6,"is_corresponding":false},{"id":1116435,"name":"Daniel Herchenhorn","orcid":"0000-0001-5166-848X","position":7,"is_corresponding":false},{"id":105165,"name":"Rana R. McKay","orcid":"0000-0002-0581-7963","position":8,"is_corresponding":false},{"id":1116914,"name":"Danielle Urman","orcid":null,"position":0,"is_corresponding":true}],"reference_count":26,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:14:23.749325Z","pmid":"37858374","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}