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Mary B. Daly, Robert Pilarski, Jennifer E. Axilbund, Saundra S. Buys, Beth Crawford, Susan Friedman, Judy E. Garber, Carolyn Horton, Virginia Kaklamani, Catherine Klein, Wendy Kohlmann, Allison Kurian, Jennifer Litton, Lisa Madlensky, P. Kelly Marcom, Sofia D. Merajver, Kenneth Offit, Tuya Pal, Boris Pasche, Gwen Reiser, Kristen Mahoney Shannon, Elizabeth Swisher, Nicoleta C. Voian, Jeffrey N. Weitzel, Alison Whelan, Georgia L. Wiesner, Mary A. Dwyer, and Rashmi Kumar

individuals with Cowden syndrome, 23 and the lifetime risk of thyroid cancer (follicular or papillary) has been estimated at 3% to 10%. 11 , 24 A higher cumulative lifetime risk of thyroid cancer (21%-38%) was reported in several recent studies in

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Robert J. Motzer, Eric Jonasch, Neeraj Agarwal, Sam Bhayani, William P. Bro, Sam S. Chang, Toni K. Choueiri, Brian A. Costello, Ithaar H. Derweesh, Mayer Fishman, Thomas H. Gallagher, John L. Gore, Steven L. Hancock, Michael R. Harrison, Won Kim, Christos Kyriakopoulos, Chad LaGrange, Elaine T. Lam, Clayton Lau, M. Dror Michaelson, Thomas Olencki, Phillip M. Pierorazio, Elizabeth R. Plimack, Bruce G. Redman, Brian Shuch, Brad Somer, Guru Sonpavde, Jeffrey Sosman, Mary Dwyer, and Rashmi Kumar

are RCC, and approximately 80% of these are clear cell tumors. 2 , 3 Other less common cell types include papillary, chromophobe, translocation, and Bellini duct (collecting duct) tumors. Medullary renal carcinoma is a variant of collecting duct renal

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NCCN Guidelines Insights: Kidney Cancer, Version 1.2021

Featured Updates to the NCCN Guidelines

Robert J. Motzer, Eric Jonasch, Shawna Boyle, Maria I. Carlo, Brandon Manley, Neeraj Agarwal, Ajjai Alva, Katy Beckermann, Toni K. Choueiri, Brian A. Costello, Ithaar H. Derweesh, Arpita Desai, Saby George, John L. Gore, Naomi Haas, Steven L. Hancock, Christos Kyriakopoulos, Elaine T. Lam, Clayton Lau, Bryan Lewis, David C. Madoff, Brittany McCreery, M. Dror Michaelson, Amir Mortazavi, Lakshminarayanan Nandagopal, Phillip M. Pierorazio, Elizabeth R. Plimack, Lee Ponsky, Sundhar Ramalingam, Brian Shuch, Zachary L. Smith, Bradley Somer, Jeffrey Sosman, Mary A. Dwyer, and Angela D. Motter

/everolimus. The investigators reported an objective response rate (ORR) of 25.8% (95% CI, 11.9%–44.6%); 8 patients in the trial achieved a partial response (PR; papillary, n=3; chromophobe, n=4; unclassified, n=1) and none had a complete response (CR). At the time

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Thomas W. Flaig, Philippe E. Spiess, Neeraj Agarwal, Rick Bangs, Stephen A. Boorjian, Mark K. Buyyounouski, Sam Chang, Tracy M. Downs, Jason A. Efstathiou, Terence Friedlander, Richard E. Greenberg, Khurshid A. Guru, Thomas Guzzo, Harry W. Herr, Jean Hoffman-Censits, Christopher Hoimes, Brant A. Inman, Masahito Jimbo, A. Karim Kader, Subodh M. Lele, Jeff Michalski, Jeffrey S. Montgomery, Lakshminarayanan Nandagopal, Lance C. Pagliaro, Sumanta K. Pal, Anthony Patterson, Elizabeth R. Plimack, Kamal S. Pohar, Mark A. Preston, Wade J. Sexton, Arlene O. Siefker-Radtke, Jonathan Tward, Jonathan L. Wright, Lisa A. Gurski, and Alyse Johnson-Chilla

-grade disease. A small fragment of tumor with few muscle fibers is inadequate for assessing the depth of invasion and guiding treatment recommendations. When a large papillary lesion is noted, more than one session may be needed to completely resect the tumor

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Saby George, Roberto Pili, Michael A. Carducci, and Jenny J. Kim

include clear cell RCC (75%), papillary RCC (15%), chromophobe type (5%), and oncocytic type tumors. Furthermore, clear cell RCC, the most common and extensively studied histologic subtype, is characterized in most cases by distinctive features, including

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Robert I. Haddad

to better diagnosis. Thyroid cancer deaths, however, are rare, with only about 1800 a year despite the high cancer incidence, Dr. Haddad added. Most cases of thyroid cancer are differentiated thyroid cancers (83% papillary, 11% follicular). The more

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Peter E. Clark, Philippe E. Spiess, Neeraj Agarwal, Rick Bangs, Stephen A. Boorjian, Mark K. Buyyounouski, Jason A. Efstathiou, Thomas W. Flaig, Terence Friedlander, Richard E. Greenberg, Khurshid A. Guru, Noah Hahn, Harry W. Herr, Christopher Hoimes, Brant A. Inman, A. Karim Kader, Adam S. Kibel, Timothy M. Kuzel, Subodh M. Lele, Joshua J. Meeks, Jeff Michalski, Jeffrey S. Montgomery, Lance C. Pagliaro, Sumanta K. Pal, Anthony Patterson, Daniel Petrylak, Elizabeth R. Plimack, Kamal S. Pohar, Michael P. Porter, Wade J. Sexton, Arlene O. Siefker-Radtke, Guru Sonpavde, Jonathan Tward, Geoffrey Wile, Mary A. Dwyer, and Courtney Smith

. 9 , 10 A reduced (one-third) dose of BCG has been evaluated for the possible reduction of side effects. In a phase III study, 1,316 patients with intermediate- or high-risk Ta, T1 papillary carcinoma of the bladder were randomized to receive either

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Eric Jonasch

bevacizumab/everolimus is useful in select patients with advanced papillary RCC, including those with germline mutations for hereditary leiomyomatosis and RCC (HLRCC). “I’ve tried this combination and have observed dramatic responses in patients with HLRCC

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Mark D. Tyson and Sam S. Chang

that they are at high risk of recurrence compared with those with pT1a tumors. Lastly, metachronous renal tumors in either the ipsilateral or contralateral kidney are found in as many as 20% of patients with papillary RCC or familial RCC. 14 Taken

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Victor T.G. Lin, Lisle M. Nabell, Sharon A. Spencer, William R. Carroll, Shuko Harada, and Eddy S. Yang

cancers, including high-grade colorectal neuroendocrine tumors, 22 papillary thyroid carcinoma, 23 and endometrial cancer. 24 To our knowledge, this is the first report of a patient with BRAF -mutated SDC treated with combined BRAF and MEK inhibition