Kidney Cancer

Bradley McGregor, MD, explains how despite the groundbreaking immunotherapy-based advances in metastatic renal cell carcinoma, unmet medical needs remain.

Adjuvant pembrolizumab reduced the risk of disease recurrence or death versus placebo in the phase 3 KEYNOTE-564 trial, but overall survival data are still immature.

Neoadjuvant stereotactic ablative radiation followed by radical nephrectomy and thrombectomy was safe and showed signs of positive clinical activity in patients with renal cell carcinoma and inferior vena cava tumor thrombus.

The guideline was initially published in 2013 and was last amended in 2017.

"Certainly, telemedicine is not a replacement for in-person encounters for all urologic conditions, but rather another tool in our armamentarium," writes Adele M. Caruso, DNP, CRNP, FAANP.

Overall survival was similar between patients selecting primary intervention or active surveillance.

Frontline immune checkpoint inhibitor therapy may improve overall survival in this setting.

Around the Practice: High-Risk Renal Cell Carcinoma

"Brain imaging is routinely obtained for kidney cancer patients with symptoms that suggest CNS metastases, but none of the patients with brain metastases included here were symptomatic," said Martin H. Voss, MD.

Substudy 03B is enrolling patients with disease progression after treatment with PD-1/PD-L1 inhibitors and VEGF-tyrosine kinase inhibitors.

The phase 3 KEYNOTE-564 trial remains ongoing to evaluate the key secondary end point of overall survival.

This recommendation is key for urologists to be aware of, in particular, because of the role of the multidisciplinary approach to renal cell carcinoma care, according to Eric Jonasch, MD.

Primo Lara, Jr, MD, highlights the multitude of available treatments in frontline renal cell carcinoma, and the need for individualized, multidisciplinary treatment in this setting.

The study is comparing the triplet regimen with nivolumab/ipilimumab alone as a frontline treatment for patients with advanced intermediate- or poor-risk renal cell carcinoma.

The approval was based on data from the pivotal phase 3 CheckMate-9ER trial.

Dr. Primo Lara, Jr., executive associate dean for Cancer Programs, School of Medicine, at UC Davis Comprehensive Cancer Center, highlights the need for personalized medicine using multidisciplinary care for patients with renal cell carcinoma.

Tivozanib is approved by the FDA for the treatment of adult patients with relapsed or refractory advanced renal cell carcinoma who have received 2 or more prior systemic therapies.

Michael E. Hurwitz, MD, PhD, discusses how immune checkpoint inhibitors have transformed the first-line setting in advanced renal cell carcinoma.

Tivozanib is approved by the FDA for the treatment of adult patients with relapsed or refractory advanced renal cell carcinoma who have received 2 or more prior systemic therapies.

The FDA is scheduled to decide on the new drug application by September 15, 2021.

Following the recent FDA approval of tivozanib in renal cell carcinoma (RCC), the VEGF-TKI is now being explored in combination with the PD-1 inhibitor nivolumab in the phase 3 TiNivo-2 trial in patients with relapsed/refractory RCC.

The FDA has approved tivozanib for kidney cancer.

The combination regimen shrank tumors and led to disease control in the majority of patients.

An expert panel discusses the case of a 65-year-old Caucasian male who is noted to have an incidental 3-cm right renal mass, enhancing on a contrasted CT scan as part of a routine follow-up for his metastatic castration-resistant prostate cancer, diagnosed in 2017 and currently undergoing therapy.

The European Commission is reviewing data from the pivotal phase 3 CheckMate-9ER trial.

Adding the off-the-shelf, cell-based immunotherapy ilixadencel to frontline sunitinib was associated with an overall survival benefit in patients with metastatic renal cell carcinoma.

Motzer highlights the overall survival benefit achieved with the combination of the PD-1 inhibitor and the multikinase inhibitor versus standard sunitinib in the phase 3 CLEAR trial.

The study assessed factors associated with survival outcomes in patients with metastatic clear cell renal cell carcinoma receiving immune checkpoint inhibitors.

Published data show the PD-1 inhibitor induced strong antitumor activity in patients with both advanced clear cell renal cell carcinoma (ccRCC) and advanced non-ccRCC.

The phase 3 ZIRCON trial is assessing TLX250-CDx as a noninvasive tool to identify clear cell renal cell carcinoma in patients with indeterminate renal masses.