Search Results

You are looking at 1 - 10 of 43 items for :

  • "Renal cell cancer" x
  • Refine by Access: All x
Clear All
Full access

Matthew P. Banegas, Linda C. Harlan, Bhupinder Mann, and K. Robin Yabroff

In 2013, approximately 65,150 individuals in the United States were diagnosed with renal cell cancer (RCC). 1 Most (>60%) will have localized disease at diagnosis, although recurrences will develop in approximately 40% of patients initially

Full access

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

-2 . J Immunother 2001 ; 24 : 287 – 293 . 19 Rosenberg SA Yang JC Topalian SL . Treatment of 283 consecutive patients with metastatic melanoma or renal cell cancer using high-dose bolus interleukin 2 . JAMA 1994 ; 271 : 907 – 913

Full access

Toni K. Choueiri

For the treatment of advanced renal cell cancer (RCC), 7 targeted agents have been approved in less than 8 years, which has greatly extended progression-free survival (PFS; Table 1 ). As even more targeted agents emerge from the pipeline, the

Full access

Irbaz Bin Riaz, Saad Ullah Malik, Muhammad Husnain, Qurat Ul Ain Riaz Sipra, Warda Faridi, Farva R. Gondal, Thanh Ho, Siddhartha Yadav, Zhen Wang, and Manish Kohli

Background: Four large RCTs (ASSURE, S-TARC, PROTECT, ATLAS) tested adjuvant VEGF-TKI therapy in high risk RCC. The results were variable for efficacy and there were concerns for increased toxicity and decline in quality of life (QoL). We performed an updated meta-analysis including results of ATLAS trial to asses a risk-benefit for adjuvant post-operative treatments in high risk RCC patients by assessing reported disease-free survival (DFS), overall survival (OS), and toxicity endpoints. Methods: Literature search was done using Medline, CENTRAL, and Embase. The DerSimonian and Laird random effects model was used to pool estimates for DFS, OS, and common side effects across the 4 trials. A subgroup analysis was performed for sunitinib alone because of its FDA approval. Heterogeneity was assessed with Cochrane Q statistic and was quantified with I2 test. Risk for bias was assessed using the Cochrane Collaboration’s tool. Results: The 4 RCTs included 4,820 patients. Adjuvant therapy with TKIs yielded no significant improvement in DFS or OS as compared to placebo (DFS HR=0.916; 95% CI, 0.832–1.009 and OS HR=1.09; 95% CI, 0.886–1.150). Separate analysis of DFS in sunitinib vs placebo did not show any benefit (2 studies, N=1,909; HR=0.90; 95% CI, 0.67–1.19). Use of TKIs was associated with significantly increased risk of drug toxicity. Increased risk of grade 3 or 4 adverse events (RR=5.110; 95% CI, 3.765–6.935), diarrhea (RR=10.725; 95% CI, 4.672–24.622), fatigue (RR=3.310; 95% CI, 1.879–5.829), hypertension (RR=4.274; 95% CI, 3.452–5.292) and palmar/plantar dysesthesia (RR=20.53; 95% CI, 9.006–46.801) was observed. There was no statistically significant heterogeneity amongst included trials. QoL endpoints were inconsistently reported. Risk of bias was low. Conclusions: This pooled analysis provides further evidence that there is no OS or DFS benefit associated with adjuvant TKI treatment. There was a significantly increased risk of grade 3 or 4 toxicity in greater than half of the patient population leading to decline in QoL during TKI therapy. Carefully selected very high-risk patients who can tolerate these agents without dose modifications may benefit from adjuvant TKI approach.

Full access

Patricia Thompson and Mayer Fishman

. Immunotherapy of metastatic renal cell cancer . Review . Cancer Control 2002 ; 9 : 293 – 304 . 3 Motzer RJ Bander NH Nanus DM . Renal-cell carcinoma . N Engl J Med 1996 ; 335 : 865 – 875 . 4 Motzer RJ Mazumdar M Bacik J . Survival

Full access

Daniel Y. C. Heng and Toni K. Choueiri

The treatment of metastatic renal cell carcinoma (RCC) has changed dramatically with the introduction of targeted therapies against vascular endothelial growth factor and the mammalian target of rapamycin. Because patients with clear cell histology account for more than 80% of patients with RCC, little evidence is available on treating patients with non–clear cell histologies. Most clinical trials have excluded them from enrollment, except for a randomized study investigating temsirolimus. Many retrospective studies on the use of sunitinib, sorafenib, and temsirolimus in patients with non–clear cell histology have shown response rates ranging from 3.7% to 16%. Prospective studies in non–clear cell histologies are ongoing. Although response rates may not be as high as those in patients with clear cell histologies, targeted therapy may provide a clinically meaningful response. New investigational therapies are on the horizon for papillary RCC—the most-common non–clear cell RCC histology—targeting pathways specific to this histology, such as the c-MET pathway.

Full access

Angela Pecoraro, Francesco Porpiglia, and Pierre I. Karakiewicz

Canc Netw 2020 ; 18 : 1340 – 1347 . 10.6004/jnccn.2020.7577 2. Lipworth L , Morgans AK , Edwards TL , Renal cell cancer histological subtype distribution differs by race and sex . BJU Int 2016 ; 117 : 260 – 265 . 10.1111/bju.12950

Full access

Michael P. Porter and Paul H. Lange

– 1670 . 24 Cadeddu JA Ono Y Clayman RV . Laparoscopic nephrectomy for renal cell cancer: Evaluation of efficacy and safety: A multicenter experience . Urology 1998 ; 52 : 773 – 777 . 25 Chan DY Cadeddu JA Jarrett TW

Full access

Robert J. Motzer, Neeraj Agarwal, Clair Beard, Graeme B. Bolger, Barry Boston, Michael A. Carducci, Toni K. Choueiri, Robert A. Figlin, Mayer Fishman, Steven L. Hancock, Gary R. Hudes, Eric Jonasch, Anne Kessinger, Timothy M. Kuzel, Paul H. Lange, Ellis G. Levine, Kim A. Margolin, M. Dror Michaelson, Thomas Olencki, Roberto Pili, Bruce G. Redman, Cary N. Robertson, Lawrence H. Schwartz, Joel Sheinfeld, and Jue Wang

alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer . N Engl J Med 2001 ; 345 : 1655 – 1659 . 23 Mickisch GH Garin A van Poppel H . Radical nephrectomy plus interferon-alfa-based immunotherapy compared with