Angiogenic ccRCC tumors show higher pancreatic metastasis rate in phase II trial

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The Journal of clinical investigation Published May 16, 2026 Medically reviewed May 16, 2026 Study authors: Haddad Gaelle, Guo Junyu, Xi Yin, Albayrak Emin, Huseni Mahrukh, Hamidi Habib, Banchereau Romain, Ka… PubMed ↗ NCT01984242 ↗ DOI ↗ By Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

Key Takeaway

Consider that angiogenic ccRCC tumors may have distinct metastatic patterns, but these post-hoc findings need validation.

This phase II RCT analyzed 305 treatment-naive clear-cell renal cell carcinoma (ccRCC) patients from a multicenter trial. Patients received atezolizumab, atezolizumab/bevacizumab, or sunitinib. The analysis classified tumors into angiogenic (clusters 1 and 2) and proliferative (clusters 4 and 5) subtypes.

Angiogenic tumors had a significantly higher rate of pancreatic metastases (21% vs. 6.9%; P=0.002) but a lower absolute number of lymph node metastases (2.5 vs. 4.2; P=0.006). Proliferative tumors had a higher absolute number of lymph node metastases (5.5 vs. 3.5; P=0.019).

Among patients with pancreatic metastases receiving sunitinib, there were higher odds of overall response (OR, 7.13; 95% CI, 1.81-28.07; P=0.0049) and longer progression-free survival (P=0.02). Safety data were not reported.

Key limitations include the post-hoc nature of the analysis and limited sample size. These findings are exploratory and require validation. Clinically, the results suggest that tumor subtype may influence metastatic patterns and treatment response, but no causal conclusions can be drawn.

Study Details

Study typeRct

EvidenceLevel 2

PublishedMay 2026

PMID42138077

TrialNCT01984242

View Original Abstract ↓

BACKGROUNDThe relationship between molecular subgroups in clear-cell renal cell carcinoma (ccRCC) and metastatic tropism is poorly understood.METHODSWe analyzed over 5,000 metastatic sites from 305 treatment-naive ccRCC patients in the IMmotion150 phase II clinical trial, where patients were randomized to atezolizumab, atezolizumab/bevacizumab, or sunitinib.RESULTSAngiogenic tumors (clusters 1 and 2) had a higher rate of pancreatic (21% vs. 6.9%; P = 0.002) and lower absolute number of lymph node (2.5 vs. 4.2; P = 0.006) metastases. In contrast, proliferative tumors (clusters 4 and 5) exhibited a higher absolute number of lymph node metastases (5.5 vs. 3.5; P = 0.019). Patients with pancreatic metastases receiving sunitinib had higher odds of overall response (OR, 7.13; 95% CI, 1.81-28.07; P = 0.0049) and longer progression-free survival than those without pancreatic metastases (P = 0.02).CONCLUSIONccRCC metastatic tropism relates to molecular clusters that predict response to therapy for tumors that metastasize to the pancreas.TRIAL REGISTRATIONClinicalTrials.gov NCT01984242FUNDINGNIH grants R01CA154475 and P50CA196516.