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- W2891627941 abstract "e16585 Background: There are multiple case reports of spontaneously regressing metastatic RCC and M patients but little information about the natural history of disease after regression has been documented. We present a series of patients with spontaneously regressing RCC and M followed prospectively after documentation of tumor shrinkage. Methods: In 2003, we obtained IRB approval for an observation protocol for patients with SR of metastatic RCC or M to collect clinical-pathologic data and blood specimens. We defined a spontaneous regression based on any reduction in tumor size that persisted for more than 8 weeks in the absence of systemic therapy. No systemic anti-tumor therapy was given if the SR was maintained. Clinical and radiologic follow up was done regularly and updated 01/29/2018. Time to documentation of regression was determined and overall survival (OS) from surgery/most recent progression to documented regression was estimated by the Kaplan-Meir Method. Results: Between 2003 and 2018, 19 patients with a SR of metastatic RCC (15) and M (4) were identified. Patient and tumor characteristics are as follows: all patients were white, median age 55 years (41-69), 32% female, 14 (73%) had biopsy confirmed metastasis. There was a 2:1 left-sided predominance of RCC (66% vs 33%) with 14 (93%) clear cell. Sites of RCC metastasis included distant lymph nodes (67%), lung (67%), liver (7%) and bone (20%). Two (13%) RCC patients received systemic cytokine therapy prior to nephrectomy. All had nephrectomy before SR was documented. 2 (50%) M patients progressed on adjuvant therapy prior to documentation of SR. The median time from nephrectomy to SR in RCC was 101 days (49-336) and median time from the diagnosis of metastases was 99 days (68-112) for M. Median OS for RCC was 56.3 months (3.1- 204.2) and for metastatic M was 175.6 months (119.1- 215.4). Five (33%) of the RCC and none of the M patients relapsed after documented SR. Median time to relapse after SR was 476 days (116-1100). Conclusions: While SR remains rare, it may occur within 3-4 months of diagnosis of metastatic RCC/M. In our cohort, it is associated with prolonged remission. Immunologic correlates are being explored" @default.
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- W2891627941 date "2018-05-20" @default.
- W2891627941 modified "2023-10-03" @default.
- W2891627941 title "Clinical features and survival outcomes in a prospective spontaneous regression (SR) protocol of renal cell carcinoma (RCC) and melanoma (M) patients." @default.
- W2891627941 doi "https://doi.org/10.1200/jco.2018.36.15_suppl.e16585" @default.
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