Kidney Cancer

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.

“The biggest question that arose from this is, ‘Why is there such a lack of large familial genetic disorder epidemiological studies?’ says Laura Bukavina, MD, MPH.

“We need to continue to push the field forward, and the way we do that is to evaluate the risk factors and to stratify patients based on their risk factors and their genetic components,” says Laura Bukavina, MD, MPH.

"What was surprising to me is that the incidence [of kidney cancer] has leveled off over the past 2 years," says Laura Bukavina, MD, MPH.

“Due to the rarity and poor molecular characterization of nccRCC, there is an underrepresentation in clinical trials evaluating patients with this type of RCC; because of this, patients are often treated with non-tailored therapies,” the researchers wrote.

Findings shared during the 2022 International Kidney Cancer Symposium showed that patients with advanced renal cell carcinoma treated upfront with pembrolizumab plus lenvatinib were far less likely to need second-line therapy vs patients receiving first-line sunitinib.

The updated results were shared at the 2022 International Kidney Cancer Symposium.

“The association between CKD and end-stage renal failure and increasing risk of kidney cancer is a really striking and important association to be aware of,” says Sarah P. Psutka, MD, MS.

"Up-front CN is associated with a survival benefit in selected patients with mRCC treated with either targeted therapy or ICI therapy," writes Badar M. Mian, MD.

“We really need to understand patient selection and treatment sequencing,” says Rana McKay, MD.

Rana McKay, MD, says that given the frontline shift from anti-VEGF monotherapy to immunotherapy doublets for advanced renal cell carcinoma, many of the studies informing the second-line setting have become “somewhat antiquated.”

Rana McKay, MD, says the CheckMate-214, KEYNOTE-426, CheckMate-9ER, and CLEAR trials have revolutionized the first-line treatment paradigm in advanced renal cell carcinoma.

“There has never been a clinical trial for these patients. It is unclear whether these patients should be treated with medication, surgery, or another approach. This represents an unmet medical need,” said Raquibul Hannan, MD, PhD.

The focus of the analysis was to determine the HRQOL of patients who were enrolled on the phase 3 KEYNOTE-426 trial.

Patients in the CheckMate-914 trial had received radical or partial nephrectomy and were at moderate or high risk of relapse.

“Survival differences can be due in part to genetic differences, but also a lot of socioeconomic issues as well,” says Ridwan Alam, MD.

Ridwan Alam, MD, discusses research exploring nonclinical factors affecting overall survival in patients with renal cell carcinoma.

Exelixis plans to discuss the top level results of the phase 3 COSMIC-313 trial with the FDA regarding a potential application submission for the triplet in this setting.

“One of the processes that is regulated by HIF2α is angiogenesis,” says James Brugarolas, MD, PhD.

Understanding the mechanisms of treatment resistance is among the areas of unmet need, says James Brugarolas, MD, PhD.

Tivozanib (Fotivda) 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.