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Metastatic Renal Cell Carcinoma - DOAJ

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Last Updated: 23 April 2022

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Current Management of Advanced and Metastatic Renal Cell Carcinoma

Introduction: Unresectable renal cell carcinoma is a medically incurable disease. Our aim was to investigate the clinical relevance of various systemic agents and surgery in the treatment of advanced RCC, as well as recommendations for practice in the light of new literature. Conclusions: Advanced RCC therapy has undergone a significant shift with the development of specific agents and potent angiogenesis inhibitors. When mixed with interferon-alpha, small-molecule multikinase inhibitors targeting vascular endothelial growth factor receptors have a favorable toxicity profile, prolonging the survival time and preserving quality of life; bevacizumab enhances the response rate and prolongs disease protection when compared to interferon-alpha. Temsirolimus, a mammalian inhibitor of rapamycin inhibitor, extends the survival duration of patients with low-risk disease. Surgery continues to play a significant role in the care of stage IV RCC patients. Systemic therapeutic agents are already showing promising results.

Source link: https://doaj.org/article/d0a33a088fb64004acf39dc90c239cbf


Development of coronary artery stenosis in a patient with metastatic renal cell carcinoma treated with sorafenib

BACKGROUND: Tyrosine kinase inhibitors are now approved for the treatment of metastatic renal cell carcinoma. Hypertension, left ventricular ejection fraction dysfunction, congestive heart failure, and arterial thromboembolic events can be caused by the cardiotoxic effects of sorafenib and sunitinib. Only three cases of coronary artery disease related to sorafenib therapy have been reported in the literature, and the majority were due to arterial vaping without evidence of coronary artery stenosis on angiography. Case report We present a patient who had unexpected cardiac disease following 2 years of sorafenib therapy. A 58-year-old man with mRCC developed acute coronary syndrome associated with critical sub-occlusion of the common trunk of the left coronary artery and some of its branches, which was first described on coronary angiography. Conclusions: A further investigation of a larger patient population is required to better understand cardiac damage caused by TKI therapy.

Source link: https://doi.org/10.1186/1471-2407-12-231


Sunitinib Does Not Accelerate Tumor Growth in Patients with Metastatic Renal Cell Carcinoma

We investigated results from the pivotal randomized phase III trial comparing sunitinib and interferon alfa in patients with metastatic renal cell carcinoma to determine whether sunitinib accelerates tumor formation in humans. Specifically, neither longer sunitinib therapy nor a larger effect of sunitinib on tumors reduced survival. Patients receiving sunitinib have no problems, and they will not be restricted to similar agents.

Source link: https://doi.org/10.1016/j.celrep.2013.01.015


Changes in therapy and survival of metastatic renal cell carcinoma in Estonia

In the case of the introduction of new medications, our aim was to investigate the changes in therapies and overall survival of all mRCC patients in Estonia. Methods The Estonian Health Insurance Fund identified all patients with mRCC who began medical therapy in Estonia between 2004 and 2012 using the Estonian Health Insurance Fund's website. Patients were divided into two groups: INFa therapy only and INFa, followed by targeted agents or targeted agents therapy only for survival analysis. Group 1 had a nearly four times higher risk of death than group 2 in multivariate analysis [hazard ration 3. 88, 95% CI 2. 64–5. 72]. Conclusions The introduction of targeted therapies improved the results of mRCC in Estonia: it prolonged median survival, reduced the risk of death, and increased the number of patients receiving medical care.

Source link: https://doi.org/10.1186/s12885-020-6685-y


Cost-effectiveness of pazopanib versus sunitinib for metastatic renal cell carcinoma in the United Kingdom.

The only two approved therapies for locally advanced or metastatic renal cell carcinoma treatment are those developed by the UK's National Institute for Health and Care Excellence, with Sunitinib and pazopanib. In the phase III COMPARZ trial, Pazopanib demonstrated non-inferior capability and a differentiated safety profile versus sunitinib. Based on results from COMPARZ and other sources, the latest report gives a realistic comparison of pazopanib's cost-effectiveness against sunitinib over five years. In most scenarios investigated by deterministic sensitivity tests, Pazopanib was found to be a more cost-effective therapy option than sunitinib in the United Kingdom's first-line treatment of mRCC.

Source link: https://doi.org/10.1371/journal.pone.0175920


The Value of PD-L1 Expression as Predictive Biomarker in Metastatic Renal Cell Carcinoma Patients: A Meta-Analysis of Randomized Clinical Trials

Immune checkpoint inhibitors have dramatically improved the results, particularly in renal cell carcinoma induced by a subset of kidney tumors, with remarkably improved longevity. According to PRISMA guidelines, we conducted a review of randomized clinical trials comparing ICIs to standard of care in metastatic RCC patients to determine the role of PD-L1 expression as a potential predictive biomarker for the use of ICIs in RCC patients. Differential expression of PD-L1 on tumor samples could identify a subset of patients who could profit more from PFS, but it did not seem to have an effect on OS findings. PD-L1 may be a biomarker to compare PFS in clinical trials, but its value for OS is less clear. The usefulness of PD-L1 expression as a predictive biomarker to select therapy in metastatic RCC patients was not evident in this meta-analysis.

Source link: https://doi.org/10.3390/cancers12071945


Prolonged survival after sequential multimodal treatment in metastatic renal cell carcinoma: two case reports and a review of the literature

In patients with metastatic clear cell carcinoma, we underline the effect of nephrectomy, sequential therapy based on cytokines, immunogeniogenic factors, and mammalian target of rapamycin inhibitors as well as metastasectomy on overall survival and quality of life in patients with metastatic clear cell renal carcinoma in this case series and short review of the literature. Case description in the first of two cases A 53-year-old Caucasian man underwent radical left nephrectomy for renal cell cancer and recovered with a bone metastasis in his right humerus during the initial case. The disease stayed largely unchanged until September 2009, when he died of allergic shock after a blood transfusion, nine years since the first diagnosis of renal cell carcinoma. In the second case, a 54-year-old Caucasian man underwent radical left nephrectomy for renal cell cancer. As enlarged axillary lymph nodes, chest soft tissue lesions, and thoracic spine bone metastases were seen, further developments were observed. He then met a first-generation mammalian target of rapamycin inhibitor, an antiangiogenic factor, and a second-generation mammalian target of rapamycin inhibitor and palliative radiotherapy. His disease is stable and he has a third antiangiogenic factor, leading an active life ten years since the first diagnosis of renal cell carcinoma. Conclusions One multidisciplinary approach to patients with metastatic renal cell carcinoma combines nephrectomy, metastasectomy, and radiotherapy based on cytokines and targeted therapy with medical therapy that includes medications that prevent angiogenesis, other receptor kinases, and the mammalian victim of rapamycin.

Source link: https://doi.org/10.1186/1752-1947-6-303


Metastatic renal cell carcinoma in the nasopharynx

Primary malignant or benign disorders can be misdiagnosed as primary malignant renal cell carcinomas of the nasopharynx, nasal cavity, and paranasal sinuses. The tumor cells were arranged in a trabecular pattern flanked by a layer of endothelial cells, and were pathologically characterized by a layer of endothelial cells. The patient had undergone left-nephrectomy for a kidney mass diagnosed as renal cell carcinoma three years earlier, according to a careful history. Laterally, nasopharyngeal metastatic renal cell carcinoma was diagnosed by immunohistochemical staining with CD10 and vimentin.

Source link: https://doi.org/10.4103/0377-4929.116147


First-Line Pazopanib Treatment in Metastatic Renal Cell Carcinoma: Real-World Data From a Single Chinese Center

Patients with metastatic renal cell carcinoma have varied in Western and Eastern populations, with pazopanib's reaction in patients with metastatic renal cell carcinoma. We reviewed the safety and side effects of pazopanib as first-line therapy in 31 consecutive patients with mRCC who were treated in a single Chinese center in 31 patients with mRCC. Between October 2017 and July 2019, pazopanib was used by thirty-one consecutive patients with mRCC. RCC patients had a pathological diagnosis of RCC before radical nephrectomy or biopsy. Patients with a median follow-up of 12. 7 months, 34. 5% had stable disease, seven patients had disease progression, and one patient had died after being lethargic. Remissions occurred in virtually all patients with local recurrence or pulmonary metastases, according to the authors, whereas PD occurred in patients with bone, liver, or brain metastases. Different metastatic lesions may have a different sensitivity to pazopanib.

Source link: https://doi.org/10.3389/fphar.2020.517672


Delayed nivolumab‐induced hepatotoxicity during pazopanib treatment for metastatic renal cell carcinoma: An autopsy case

We report a case in which a patient died of severe hepatitis that was believed to have been caused by the drug of nivolumab and pazopanib for metastatic renal cell carcinoma. Case description The 74-year-old male with metastatic renal cell carcinoma was treated with nivolumab as a third-line therapy. About two months after the final dose of nivolumab was administered, pazopanib was introduced as a fourth-line therapy. The patient suffered from lethal hepatic failure and died 18 days after the start of pazopanib therapy. CD8-positive lymphocytes had infiltrated the thyroid gland and liver, according to an autopsy.

Source link: https://doi.org/10.1002/iju5.12101

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions