Kidney Cancer

Investigators assessed integration of mGPS for risk stratification based on data from the phase 3 IMmotion151 study and the phase 2 IMmotion150 study.

"Clinicians have opportunities to reduce patient subjective and objective financial burden if they continue to self-educate and communicate with patients and consider [financial toxicitiy] an adverse effect of treatment," write Alexandria A. Spellman, MD, MS, and Deborah R. Kaye, MD, MS.

"The emulation framework lends the design and conduct of observational analyses some of the rigor required for the planning of a randomized trial. In doing so, it provides an innovative and principled approach to improve the evidence base on the comparative effectiveness of interventions," writes Boris Gershman, MD, and Aaron Fleishman, MPH.

"Even though most urologists who do retroperitoneal surgery do it for posterior tumors, you actually can do it equally well with as equally good success for an anterior tumor," says Michael D. Stifelman, MD.

"We found out the using IRIS intraoperatively during partial nephrectomy does help us with preserving renal parenchyma," says Teona Iarajuli.

Increasing numbers of older patients with cancer necessitates adoption of an age-friendly approach to cancer care.

Trajectory inference analysis pointed to SIX2+CITED1+ as the nephrogenic cancer stem cells at the origin of Wilms tumor.

Adding cabozantinib to nivolumab/ipilimumab improved PFS in frontline renal cell carcinoma; however, there was increased toxicity with the triplet, including more adverse event–related discontinuations.

The phase 3 RENOTORCH study is comparing the combination of the PD1-inhibitor toripalimab and axitinib with single-agent sunitinib in patients with renal cell carcinoma.

Results from the phase 1 TRAVERSE trial showed signals of anti-tumor activity with the CAR T-cell therapy ALLO-316 in patients with advanced or metastatic clear cell renal cell carcinoma.

The AACU joined thirteen other organizations in asking the House and Senate appropriations committees to allocate $60 million in FY24 for the KCRP at the Congressionally Directed Medical Research Programs.

In combination, the number of immune cells in and around kidney tumors, the amount of dead cancer tissue, and the mutations of PBRM1 can serve as biomarkers of response to immunotherapy in patients with kidney cancer.

The phase 2 LITESPARK-003 study explored belzutifan plus cabozantinib in patients with locally advanced or metastatic clear cell renal cell carcinoma.

At 5-year follow-up, overall survival among patients with kidney cancer who had quit smoking was 85% compared with 61% for those that continued to smoke.

The phase 2 CaboPoint trial is exploring cabozantinib in patients with locally advanced or metastatic renal cell carcinoma who progressed after first-line checkpoint inhibitor–based combination therapy.

“These disparities are concerning as the generalizability of clinical trial results relies on the assumption that the population of patients included in a clinical trial represents the overall population of patients with the disease," says Brian M. Shinder, MD.

The median overall survival in renal cell carcinoma patients was similar, regardless of whether or not patients received a break from treatment.

“Now in 2023, it’s really a question of how to apply these agents and which combinations to use in the first line,” said Vincent (Wenxin) Xu, MD.

“As a whole, the benefits of the lenvatinib plus pembrolizumab combination proved to be durable, statistically significant, and clinically meaningful,” said senior author Camillo Porta, MD.

“Same-day discharge after partial nephrectomy in properly selected patients is safe and cost effective for both patients and the health system,” says Andrew Wood, MD.

Published results from the phase 3 CONCEPT study showed improved outcomes with the combination compared with either agent alone.

“I am seeing this process rapidly expand, particularly with the use of the single-port robot, which offers additional benefits to things like pain control and helps to further expedite early discharge,” Andrew Wood, MD.

The patient presented with a large right renal mass who elected for right radical nephrectomy with possible inferior vena cava.

“First and foremost is that same-day discharge appears to be safe. There were no failure-to-rescue events within 24 to 48 hours after discharge outside of the hospital,” says Andrew Wood, MD.

The phase 2 Cyto-KIK study is exploring cytoreductive surgery plus immunotherapy with nivolumab and targeted kinase inhibition with cabozantinib in metastatic kidney cancer.

“As other factors such as access to care, socioeconomic conditions, patient preference, and other unknown confounders might have played a role in the observed disparity, it is still unclear whether overestimating the postoperative eGFR of Black patients contributes to the lower use of nephron-sparing approaches in this population,” the authors write.

"Augmented biopsy-based and noninvasive options are available to reduce benign resection rates of renal tumors with the consideration of PEER and 99mTc-sestamibi SPECT/CT," writes Hiten D. Patel, MD, MPH.

As the year comes to a close, we revisit some of this year’s top content on kidney cancer.

“Ultimately it really does come down to the discussion with the patient,” says Bradley McGregor, MD.

The FDA’s Fast Track Designation is designed to expedite the review and development of novel treatments that will fill an unmet medical need.