Pd18-01 Genomic Characterization of Recurrent Urcc Tumors

You have accessJournal of UrologyKidney Cancer: Advanced (Including Drug Therapy) II (PD18)1 May 2024PD18-01 GENOMIC CHARACTERIZATION OF RECURRENT URCC TUMORS Juan S. Arroyave Villada, Lina Posada Calderon, Cerise Tang, Lennert Eismann, Mark Zucker, Stephen W. Reese, Mark Dawidek, Paul Russo, Jonathan A. Coleman, Ritesh R. Kotecha, Maria Carlo, Robert Motzer, Martin Voss, Yingbei Chen, Eduard Reznik, and Abraham A. Hakimi Juan S. Arroyave VilladaJuan S. Arroyave Villada , Lina Posada CalderonLina Posada Calderon , Cerise TangCerise Tang , Lennert EismannLennert Eismann , Mark ZuckerMark Zucker , Stephen W. ReeseStephen W. Reese , Mark DawidekMark Dawidek , Paul RussoPaul Russo , Jonathan A. ColemanJonathan A. Coleman , Ritesh R. KotechaRitesh R. Kotecha , Maria CarloMaria Carlo , Robert MotzerRobert Motzer , Martin VossMartin Voss , Yingbei ChenYingbei Chen , Eduard ReznikEduard Reznik , and Abraham A. HakimiAbraham A. Hakimi View All Author Informationhttps://doi.org/10.1097/01.JU.0001008596.32809.c5.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Unclassified Renal Cell Carcinoma (uRCC) refers to a subset of renal tumors that cannot be adequately classified within the common RCC subtypes and typically follow an aggressive disease course. Genetically characterizing uRCC and possible associated genomic alterations, can result in improved and individualized oncologic treatment. We describe and compare genomic alterations in our patients and stratify our cohort by recurrence status. METHODS: We retrospectively reviewed demographic and oncologic data from our prospectively collected institutional database to identify patients undergoing surgery for localized uRCC from 2003-2022. Corresponding genomic data was retrieved from our institutional database (MSK-IMPACT). Wilcoxon rank-sum test and Pearson's chi-squared tests were used to compare genomic data between groups. RESULTS: We examined a cohort of 60 patients with histologically confirmed uRCC. The median age at the time of nephrectomy was 60 years (IQR: 50-70). Of these patients, 58% (n=35) were male, and 38% (n=23) were former smokers. The median tumor size was 5.5 cm (IQR: 3.2-8.0), and 50% (n=30) were classified as pT3 stage.Over a median follow-up period of 51.3 months (IQR: 18.9-71.3), 55% of patients (n=33) experienced disease recurrence. 70% of those with recurrent disease had pathological T3 disease, and 33% had N1 disease, which was significantly higher compared to 26% and 0% in the non-recurrence group (p<0.001 for both comparisons).Patients with recurrent disease exhibited a higher mutational burden (0.18 vs. 0.04, p=0.002). Additionally, patients with recurrent disease had tumors with a higher mutational burden (3.9 vs. 0.9, p=0.002) and a higher microsatellite instability score (0.25 vs. 0, p=0.007) (Figure 1).The CDKN2A gene was significantly enriched in recurrent tumors compared to non-recurrent cases (21.2% vs. 0%, p=0.011). Notably, recurrent patients were more likely to have at least one clonal driver mutation in 3p-associated loci (SETD2, BAP1, PBRM1) or NF2 (55% vs. 15%, p=0.003). CONCLUSIONS: uRCC demonstrates an aggressive disease course with 55% of patients recurring. We identified genomic alterations correlating with recurrence, which may help select patients for treatment intensification, though confirmatory studies are required. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e432 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Juan S. Arroyave Villada More articles by this author Lina Posada Calderon More articles by this author Cerise Tang More articles by this author Lennert Eismann More articles by this author Mark Zucker More articles by this author Stephen W. Reese More articles by this author Mark Dawidek More articles by this author Paul Russo More articles by this author Jonathan A. Coleman More articles by this author Ritesh R. Kotecha More articles by this author Maria Carlo More articles by this author Robert Motzer More articles by this author Martin Voss More articles by this author Yingbei Chen More articles by this author Eduard Reznik More articles by this author Abraham A. Hakimi More articles by this author Expand All Advertisement PDF downloadLoading ...