To the Editor Improving outcomes in patients with renal cell carcinoma (RCC) with brain metastases remains a major challenge.1 Systemic treatment should be considered a crucial component of care, considering that most of these patients will harbor distant metastases outside the central nervous system, and brain metastases at diagnosis confer a dismal prognosis.2 In JAMA Oncology, Hirsch and colleagues3 reported the results of a cohort study of cabozantinib for patients with RCC with progressing brain metastases without concomitant brain-directed local therapy (cohort A) or with stable or progressing brain metastases concomitantly treated by brain-directed local therapy (cohort B). Many objective partial responses in the brain were noted, and median overall survival was 15 months and 16 months in cohorts A and B, respectively. Although this was a relatively small cohort study, these data are relevant to clinical practice, and the trial by Hirsch et al3 represents an interesting piece of work in this setting.
Rizzo A, Mollica V, Massari F. Cabozantinib for Treatment of Brain Metastases in Patients With Renal Cell Carcinoma. JAMA Oncol. 2022;8(5):783–784. doi:10.1001/jamaoncol.2022.0049
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