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Occult Brain Mets Detected in Patients With Advanced Renal Cancer

MONDAY, May 3, 2021 -- Occult brain metastasis is identified in about 4 percent of patients with metastatic renal cell carcinoma (mRCC), according to a study published in the April issue of the Journal of the National Comprehensive Cancer Network.

Ritesh R. Kotecha, M.D., from the Memorial Sloan Kettering Cancer Center in New York City, and colleagues retrospectively reviewed data from patients with mRCC incidentally diagnosed with asymptomatic brain metastases during screening for clinical trial participation. The analysis included data for 1,689 patients with mRCC from 68 clinical trials conducted between 2001 and 2019 with a median 14.1-month follow-up.

The researchers found that 4.3 percent of patients with mRCC harbored occult brain metastases. A majority of the 72 patients in this cohort (86 percent) had two or more extracranial sites of disease, including lung metastases (92 percent). International Metastatic RCC Database Consortium (IMDC) risk status was favorable for 26 percent, intermediate for 61 percent, and poor for 13 percent of these patients. In more than one-third of patients (38.5 percent), central nervous system involvement was multifocal, and the largest brain metastasis was >1 cm in diameter in 40 percent of the cohort. In almost all patients (93 percent), localized brain-directed therapy (predominantly radiotherapy) was pursued. Median overall survival was 10.3 months, while the one-year overall survival probability was 48 percent. There was no association noted between IMDC risk and number or size of lesions and survival.

"These data provide rationale for brain screening in patients with advanced RCC," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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