Renal Cell Carcinoma Central

The release of findings from the Checkmate-214 study produced multiple changes for specialists in renal cell carcinoma. Chung-Han Lee, MD, PhD, medical oncologist at Memorial Sloan Kettering Cancer Center, spoke with Healio about CheckMate-214 findings, clinical relevance, FDA approvals of TKI/IO regimens and possible novel agents.

Choosing the best treatment for a patient with renal cell carcinoma involves a thorough assessment of the potential advantages and drawbacks of each targeted and immune therapy option based on the patient’s risk level and adjustment based on response to frontline treatment.

The COVID-19 pandemic presents unique challenges to renal cell carcinoma patients, especially concerning treatment. Healio spoke with Matthew R. Zibelman, MD, assistant professor, department of hematology/oncology, Fox Chase Cancer Center, spoke with Healio about renal cell carcinoma treatment during the COVID-19 pandemic, the FDA approval of pembrolizumab and use of telemedicine.

With new targeted and immune-based treatments coming out for renal cell carcinoma, predictive biomarkers are needed more than ever. The many different tumor entities of RCC, their genetic and mutational alterations and different clinical behaviors all contribute to a complex disease that requires personalized treatment.

More than half of patients diagnosed with renal cell carcinoma are at least 65 years old, and the median age at diagnosis is 64. Although increased life expectancies in general and prolonged survival times as a result of targeted therapies deserve optimism, elderly patients with renal cell carcinoma also bring unique clinical challenges. Beyond medical factors, social, psychological and financial elements also influence treatment practicalities and outcomes.

Immune therapy combinations have made a tremendous impact on life expectancy and induced long-term remissions. Targeted therapy has also made big strides in improving outcomes. Cancer genomics has the potential to help us customize therapy in the future.

In February 2018, Robert J. Motzer, MD, presented results from the phase 3 IMmotion151 trial at the Genitourinary Cancers Symposium. The highly anticipated findings showed significant promise for the combination of atezolizumab plus bevacizumab in patients with untreated metastatic renal cell carcinoma when compared with the standard treatment of sunitinib. In an interview with Healio, Motzer, who was one of the lead investigators of IMmotion151 and is an attending physician at Memorial Sloan Kettering Cancer Center in New York, spoke in detail about the trial, discussing the catalyst, key findings and what the results may mean for the future of the specialty.

In 2017, the positive results of two trials — CheckMate-214 and CABOSUN — garnered a great deal of attention and discussion, and prompted many in the field to claim that a revolution is underway in the management of patients with metastatic renal cell carcinoma. To better understand the implications of these trials, Healio spoke with Neeraj Agarwal, MD, director of the genitourinary oncology program and associate professor of medicine at the Huntsman Cancer Institute at the University of Utah in Salt Lake City, who discussed the key findings, and shared his thoughts on how the landscape of metastatic renal cell carcinoma therapies may change in the coming years.

The 21st century has witnessed several practice-changing advances in managing patients with renal cell carcinoma, including a steadily growing armamentarium that has resulted in improved patient outlook. In an interview with Healio, Brian I. Rini, MD, professor of medicine at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and staff member at the Cleveland Clinic’s Taussig Cancer Institute, shared his thoughts on these changes and what drives him in research, and offered a glimpse at what he believes the future of renal cell carcinoma treatment will entail.

Recent innovations in the management of renal cell carcinoma have helped clinicians preserve the kidney during surgery and with it, kidney function for their patients. Ketan K. Badani, MD, professor of urology at the Icahn School of Medicine at Mount Sinai Hospital and director of the comprehensive kidney cancer program at Mount Sinai Health System in New York, spearheaded one of these advances: the first assistant sparing technique for robotic partial nephrectomy. In an interview with Healio, Badani spoke about the advantages of this technique, the limitations with current robotic nephrectomy, how he handles patient education and more.