Targeted Therapy for Metastatic Urothelial Cancer: A Work in Progress ONCOLOGY GRAND ROUNDS

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 64-year-old man presented to the clinic to discuss treatment options for progressive metastatic urothelial carcinoma (UC). At age 57 years, he underwent cystoprostatectomy for bacillus Calmette-Guérin–refractory, high-grade noninvasive UC. He was well until age 61 years, when he developed a left upper-tract UC. He underwent left nephroureterectomy, revealing locally advanced high-grade UC invading the renal parenchyma (pT3). Postoperatively, his renal function precluded adjuvant cisplatin-based chemotherapy. He enrolled onto a clinical trial of autologous cellular immunotherapy targeting human epidermal growth factor receptor 2, for which he was eligible on the basis of human epidermal growth factor receptor 2 positivity (≥ 1+ by immunohistochemistry) in his nephrectomy tumor specimen. He was randomly assigned to observation. Two years later, he developed a left pelvic mass. Biopsy confirmed metastatic high-grade UC. He was briefly treated wit...
Source: Journal of Clinical Oncology - Category: Cancer & Oncology Authors: Tags: Oncology Grand Rounds Source Type: research

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CONCLUSION: This case demonstrates the importance of excluding the cystic metastasis of a cancer when liver cysts are observed. PMID: 31143076 [PubMed - in process]
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Rationale: Collecting duct carcinoma (CDC) is a rare type of nonclear renal cell carcinoma, often presenting at an advanced stage of the disease, and standard treatment guidelines have not been established. Patient concerns: A 73-year-old man was admitted to our hospital with complaints of fever and lower right back pain. Diagnoses: Computed tomography revealed a poorly defined tumor of the right kidney without metastasis. The patient underwent right radical nephrectomy and was diagnosed with clinical stage T1bN0M0 renal cancer; the pathological findings showed collecting duct carcinoma. Interventions: After nep...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusion Incidence of metastatic renal carcinoma is increasing. Overall prognosis of patient with advanced RCC is poor, emphasizing the importance of early detection and prompt treatment of primary lesion in its early stage. Advancement in targeted therapy in recent decades had made some improvement in treatment of SREs and has helped in improving patent's quality of life but still we are in need of further improvement in treatment modalities to cure disease thereby decreasing morbidity and mortality.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
CONCLUSIONS: This is the second reported case of association between RCC and peritoneal MM in the scientific literature. Asbestos might be involved in the causation of both malignancies. PMID: 27240221 [PubMed - in process]
Source: Medicina del Lavoro - Category: Occupational Health Tags: Med Lav Source Type: research
We report a case of a 44-year-old man with a localized right renal pelvis mass treated with a right nephroureterectomy. The pathological examination showed a high-grade urothelial carcinoma of the renal pelvis, stage III (pT3aNxM0). A few days later, he developed lower back pain, hematuria, cough with hemoptoic sputum and progressive dyspnea. Radiological explorations showed multiple bilateral lung nodules and a retroperitoneal mass. A CT-guided biopsy of the retroperitoneal mass revealed a high-grade angiosarcoma. A review of the nephrectomy specimen showed a microscopic focus of angiosarcoma in the urothelial carcinoma. ...
Source: Cancer Biology and Therapy - Category: Cancer & Oncology Authors: Tags: Cancer Biol Ther Source Type: research
Conclusion: there is no increased risk of doing the lymph node dissection early on.   Dr. Eggener-CON   Basics Lymph node dissections rarely done, even for large tumors, because there is no proven therapeutic or staging benefit for low risk patients.  A Mayo study revealed no data showing therapeutic benefit in high risk patients.  For clinically node negative high risk patients, there is staging value but no proven therapeutic benefit. Rate of positive nodes is associated with stage and grade; the higher the stage and grade, the more likely there will be positive nod...
Source: Kidney Cancer Association - Category: Urology & Nephrology Source Type: news
Patient advocates generously volunteered their time to take notes at the recent 8th International Kidney Cancer Symposium, in Chicago.  These notes are intended to capture the essence of this important medical meeting and convey it in a way that is useful to patients, survivors, and their families.  The first installment sumarizes the Saturday morning session. Integration of Surgical and Systemic Therapy in Metastatic RCC  This session was opened by Dr. Bradley Leibovich who presented two cases on which the audience voted on methods to integrate surgery with systemic treatment interventions.  T...
Source: Kidney Cancer Association - Category: Urology & Nephrology Source Type: news
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