Cancers, Vol. 11, Pages 1227: The Changing Therapeutic Landscape of Metastatic Renal Cancer
Cancers, Vol. 11, Pages 1227: The Changing Therapeutic Landscape of Metastatic Renal Cancer Cancers doi: 10.3390/cancers11091227 Authors: Javier C. Angulo Oleg Shapiro The practising clinician treating a patient with metastatic clear cell renal cell carcinoma (CCRCC) faces a difficult task of choosing the most appropriate therapeutic regimen in a rapidly developing field with recommendations derived from clinical trials. NCCN guidelines for kidney cancer initiated a major shift in risk categorization and now include emerging treatments in the neoadjuvant setting. Updates of European Association of Urology clinical guidelines also include immune checkpoint inhibition as the first-line treatment. Randomized trials have demonstrated a survival benefit for ipilimumab and nivolumab combination in the intermediate and poor-risk group, while pembrolizumab plus axitinib combination is recommended not only for unfavorable disease but also for patients who fit the favorable risk category. Currently vascular endothelial growth factor (VEGF) targeted therapy based on tyrosine kinase inhibitors (TKI), sunitinib and pazopanib is the alternative regimen for patients who cannot tolerate immune checkpoint inhibitors (ICI). Cabozantinib remains a valid alternative option for the intermediate and high-risk group. For previously treated patients with TKI with progression, nivolumab, cabozantinib, axitinib, or the combination of ipilimumab and nivolumab appear the most plausible alterna...
CONCLUSIONS: It follows that the antiangiogenic activity of bevacizumab may be due to a direct effect on angiogenic cytokines released by tumor cells and an indirect effect on the release of pro-angiogenic factors by inflammatory stromal cells. PMID: 30738745 [PubMed - as supplied by publisher]
Metastatic renal cell carcinoma portends a poor prognosis with a 5-year overall survival (OS) of only 8%. We evaluated whether neoadjuvant tyrosine kinase inhibitors (TKI) prolongs OS in patients undergoing cytoreductive nephrectomy (CN) using the National Cancer Database (NCDB).
CONCLUSION: Data from the literature are not currently in favor of neoadjuvant use of targeted therapies in the treatment of kidney cancer. Prospective studies will be required to determine their interest in the prevention of metastatic recurrence after surgery. PMID: 26781767 [PubMed - as supplied by publisher]
Contributors : Carlos Dzik ; Sabrina T Reis ; Nayara Viana ; Glauber C Brito ; Isis Paloppi ; Miguel Srougi ; Katia R LeiteSeries Type : Expression profiling by arrayOrganism : Homo sapiensGene Evaluation of DNA expression from snap-frozen renal cell cancer tissue from 5 patients with locally advanced non-metastatic tumors, submitted to nephrectomy after being treated with 2 cycles of neoadjuvant Sunitinib were compared to match controls comprising of 6 patients with no neoadjuvant intervension using microarray platform Affymetrix Human Genome U133 Plus 2.0 containing 54675 probes. Validation followed using qRT-PCR
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...
We are grateful to patient advocate Katherine Phillion for sharing her notes from our fall kidney cancer meeting. Eigth International Kidney Cancer Symposium September 2009 Management of Small Renal Masses and Localized Renal Carcinoma Case Presentation and Background Robert G. Uzzo, M.D., FACS There are a lot of options available to manage small (
Eighth International Kidney Cancer Symposium September 2009 Management of Small Renal Masses and Localized Renal Carcinoma Case Presentation and Background Robert G. Uzzo, M.D., FACS There are a lot of options available to manage small (
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...