Kidney Cancer

One way of framing the ethical question in this case might be: “What are my ethical obligations to provide an anticancer therapy when I think it is unlikely to benefit the patient?” The broader clinical questions involved in this case are fundamentally the same in most patients.

A trial comparing axitinib to sorafenib as first-line therapy for metastatic renal cell carcinoma showed a statistically significant improvement in progression-free survival for the drug; however, the difference failed to meet the phase III trial’s prespecified significance level of 0.025.

Results from a retrospective analysis indicate that the use of the antiangiogenic, VEGF inhibitor sorafenib for the treatment of advanced renal cell carcinoma was well tolerated in patients aged 65 years or older.

New data suggest that surveillance of patients with small kidney tumors may be a safe alternative to surgery, especially in older patients or those with comorbid conditions.

In a new study, researchers show that sunitinib, an FDA-approved TKI for advanced renal cell carcinoma, does not result in accelerated growth of kidney tumors after discontinuing treatment.

The mTOR inhibitor everolimus (Afinitor) has been found to significantly reduce the size of angiomyolipomas, the slow-growing benign tumors commonly associated with tuberous sclerosis complex (TSC) and sporadic lymphangioleiomyomatosis, according to the results of the phase III EXIST-2 study.

A new technique of robotic partial nephrectomy has the potential for better preservation of kidney function and better cancer control during partial nephrectomy by allowing surgeons more time to perform the procedure compared with traditional open surgery, according to the results of a recently published case series.

Screening patients with renal masses with iodine-124-girentuximab had both a high specificity and sensitivity for identifying clear cell renal cell carcinoma, according to the results of a newly published open-label multicenter study.

In mid-October, Pfizer announced that its phase III study being conducted examining axitinib (Inlyta) in treatment-naive patients with advanced renal cell carcinoma failed to meet its primary endpoint of improving progression-free survival compared with sorafenib.

Black patients diagnosed with renal cell carcinoma had worse survival than white patients regardless of several patient and tumor characteristics including tumor stage and size, according to data from 39,350 patients in the National Cancer Institute’s SEER program.

A phase I study of the use of stereotactic radiosurgery as a therapeutic option for patients with localized, inoperable primary renal cancer showed that the treatment modality effectively stabilized or decreased disease in a large percentage of patients.

We describe areas where major inroads were initially achieved by targeting angiogenesis and by unraveling pathways in the heterogeneous tumors of mesenchymal origin-spurred by the identification of c-Kit–activating mutations in GIST and the regressions that ensued when tumors harboring these mutations were exposed to the tyrosine kinase inhibitor imatinib (Gleevec).

The randomized COMPARZ trial of pazopanib vs sunitinib for metastatic renal cell carcinoma found a similar response to both, but pazopanib was more tolerable.

AVEO Pharmaceuticals Inc has announced that it has submitted a new drug application for tivozanib to the US Food and Drug Administration for the treatment of metastatic renal cell carcinoma.

Results from a trial of a new therapeutic vaccine for renal cell carcinoma demonstrate that those patients with a measurable immune response to the vaccine have a prolonged overall survival.

In this issue of ONCOLOGY, Dutcher, Mourad, and Ennis provide a current review of some newer strategies in the surgical and systemic treatment options for localized and advanced renal cell carcinoma (RCC).

Drs. Dutcher, Mourad, and Ennis have provided an excellent review of current and potential future treatments of renal cell carcinoma (RCC); we would like to highlight some salient points from a urologic perspective.

In the current critical review we discuss these emerging trends in localized and systemic treatment as well as possible interesting combinations of the two modalities. Finally, we discuss the role of the new systemic agents in non–clear cell RCC.

The antiangiogenic agent pazopanib demonstrated clinically meaningful activity in patients with refractory urothelial cancer in a phase II proof-of-concept study, identifying pazopanib as the first targeted compound to have clinically meaningful activity in patients with refractory urothelial cancer.

Renal cell carcinoma (RCC) had historically been regarded as a disease that was refractory to therapy once surgical options had been exhausted.

The development of vascular endothelial growth factor (VEGF) pathway inhibitors and mammalian target of rapamycin (mTOR) inhibitors for the treatment of renal cancer is a real success story.

The article by Posadas and Figlin on systemic therapy in advanced renal cell carcinoma (RCC) provides a very interesting and comprehensive review of our current knowledge concerning the treatment of RCC.

The US Food and Drug Administration (FDA) has approved the angiogenesis blocker axitinib (Inlyta), a twice daily oral drug, as a second-line treatment for patients with advanced renal cell carcinoma.

Researchers have identified a novel rare, germline mutation linked to a predisposition for both melanoma and renal cell carcinoma (RCC) that results in a five-fold increased risk of developing melanoma, RCC, or both.

Scientists at Jennerex, Inc. in San Francisco, and collaborators from University of Pennsylvania and the University of Ottawa in Canada have just engineered a poxvirus, JX-594, to selectively replicate in tumor cells that have an activated EGFR/ Ras pathway, but not in normal tissue.

The patient is a 43-year-old man who was initially evaluated at an outside institution for unexplained anemia and who was found to have a large right kidney mass. He underwent a radical nephrectomy for a 19-cm large-cell, poorly differentiated neoplasm, consistent with pleomorphic, epithelioid angiomyolipoma (EAML) with extensive necrosis and cytologic atypia.

The authors present an interesting case of a very rare renal neoplasm, malignant epithelioid angiomyolipoma (AML), which belongs to a family of mesenchymal tumors known as perivascular epithelioid tumors (PEComas).

A retrospective study of metastatic renal cell carcinoma (mRCC) patients published in the journal Cancer found that patients treated with tyrosine kinase inhibitors (TKIs) had better overall survival and less-frequent metastasis to the brain.

Following a retrospective analysis which may be the largest of its kind to date, a multicenter team of investigators says treatment-related hypertension may be a useful biomarker of superior clinical outcome with sunitinib (Sutent) in patients with metastatic renal cell carcinoma (RCC).

My 2002 article provided an overview of the various interleukin-2 (IL-2)–based treatment regimens that had been explored over the preceding two decades