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In patients with metastatic renal cell carcinoma, cytoreductive radical nephrectomy with immunotherapy is the treatment of choice. In mRCC, there are no reports on the role of cytoreductive partial nephrectomy. Result In final analysis, the study revealed that there were 264 patients, 542 in cPN and 2127 in cRN groups. Of the preoperative results, there were significant differences in preoperative size of tumors between cRN and cPN patients, but Fuhrman grades were comparable between groups. In terms of OS rate, there was no significant difference between cPN and cRN. Conclusion In terms of CSS and OS rate, there are similar results between cPN and cRN. However, in the metastatic setting, future research will need to conduct more extensive studies using prospectively collected patient characteristics to determine the cPN and cRN.
Source link: https://europepmc.org/article/MED/35422178
Importance Metastatic collecting duct carcinoma is a rare form of non-clear cell renal cell carcinoma with poor prognosis and no standard therapies. No prospective trials have evaluated this treatment in mCDC, despite a retrospective series that has chronicled the benefit of cabozantinib in ncRCC. The aim is to determine whether cabozantinib is a safe treatment in patients with mCDC. CaBozantinib in cOllectiNg ducts Renal Cell cArcInoma trial conducted between January 2018 and November 2020 at a single academic center, with data cut off in September 2021 for the Italian Network for Urologic-Oncology. According to Response Evaluation Criteria in Solid Tumors, eligible patients had histologic diagnosis of centrally confirmed mCDC with measurable disease. Patients Received Cabozantinib 60 mg orally daily, until disease progression, ineffective toxic results, or withdrawal of consent. Objective response rate per RECIST, version 1. 1, was the primary end point. Results Attribution Failure The screening process at pathologic analysis was flawed, but 23 patients were accepted, 23 started therapy because two were excluded because of data corruption. 3 patients presented stable disease, 1 patient had a complete response, and 7 others had a partial reaction, with three patients having stable disease, 3 patients had stable disease, 1 patient had a complete response, and 7 others a partial response. All patients had at least one grade 1 to 2 adverse event, according to the FDA. Conclusions and relevance The research was conducted in accordance with the ORR primary end goal, showing promising results of cabozantinib in untreated patients with mCDC.
Source link: https://europepmc.org/article/MED/35420628
Patients with metastatic renal cell carcinoma are extremely dependent on disease monitoring based on radiological findings, which is highly dependent on goal-based therapy. Objectives: The aim of the study was to compare non-standardized, common practice free text reporting on disease response in solid tumors modified for immune-based therapeutics. Methods of Study Fifty patients with advanced mRCC were included in the retrospective, single-center study. New lesions were often not recognized if they were not already identified in the latest prior follow-up examination odds ratio for a too favorable disease response rating compared to iRECIST: 5. 4 [95% CI 2. 9-10. 1]. Conclusions Moderate agreement between disease response according to FTR or iRECIST in patients with mRCC suggests the need for standardized quantitative radiological assessment in daily clinical practice.
Source link: https://europepmc.org/article/MED/35420348
In an otherwise healthy male patient, we report unusual occurrence where metastatic renal cell carcinoma appeared as a single 2 cm subcutaneous chest wall node. A solid vascular mass, a fine needle aspiration suggested metastatic renal cell carcinoma, and later, excision biopsy, and a CT scan of the abdomen confirmed the final diagnosis of stage IV renal cell carcinoma.
Source link: https://europepmc.org/article/MED/35432677
Background The INMUNOSUN trial was designed to prospectively assess sunitinib's effectiveness and safety in patients with metastatic renal cell carcinoma who had progressed to first-line immune checkpoint inhibitor based therapies. Following package insert instructions, all patients were given sunitinib 50 mg daily orally for 4 weeks followed by a 2-week rest period. Patients with enhanced antitumor response to first-line ICI-based therapy had longer PFS and OS with sunitinib. There was one patient who developed grade 5 pancytopenia, and 11 others suffered with grade 3 adverse events. Conclusion Although the INMUNOSUN trial did not reach the pre-specified endpoint, it showed that sunitinib is active and can be safely used as a second-line option in patients with mRCC who are transitioning to newer ICI-based regimens, according to the INMUNOSUN trial.
Source link: https://europepmc.org/article/MED/35405437
The treatment of metastatic renal cell carcinoma has been revolutionized by the development of immunotherapeutic and targeted agents. Multiple products within each category have been licensed for use in the first-line therapy of clear cell and non-clear cell RCC. However, few of these regimens have been specifically reviewed, resulting in a new clinical challenge for physicians: how to choose a first-line therapy regimen for an individual patient from a field of many approved options. This paper discusses the most current first-line treatment techniques for metastatic RCC management and proposes a framework in which treatment selection can be tailored to individual patients.
Source link: https://europepmc.org/article/MED/35385828
Background We previously reported a 35-gene expression classifier that found four clear-cell renal cell carcinoma groups with varying tumour microenvironments and sensitivities to sunitinib in metastatic clear-cell renal cell carcinoma tumors. Patients with nivolumab 1 mg/kg and 3 mg/kg were placed in intravenous nivolumab 1 mg/kg every three weeks for four doses followed by intravenous nivolumab 240 mg every 2 weeks. Patients randomized to nivolumab received intravenous nivolumab 240 mg every 2 weeks. Oral sunitinib or oral pazopanib were given to patients of VEGFR-TKIs. Two patients were excluded due to a significant adverse event before the first study dose, and one patient was barred from analysis due to incorrect diagnosis. Objective responses were obtained in 12 of 42 patients with nivolumab and 16 of 41 patients with nivolumab-ipilimumab in the ccrc1 network, as well as in 16 of 41 patients with nivolumab-ipilimumab. Objective responses were found in seven of 16 patients with nivolumab and nine of 18 patients with nivolumab-ipilimumab in the ccrcc4 group, as well as nine of 18 patients with nivolumab-ipilimumab. Objective responses were observed in 18 of 36 patients with a VEGFR-TKI and 19 of 37 patients with nivolumab-ipilimumab. No objective responses were observed in the four patients who received a VEGFR-TKI and in one of five patients treated with nivolumab-ipilimumab. In the first-line treatment of metastatic clear-cell renal cell carcinoma, we show the results and positive impact of a prospective patient selection based on tumour molecular phenotype to select the most effective therapy between nivolumab with or without ipilimumab and a VEGFR-TKI.
Source link: https://europepmc.org/article/MED/35390339
Using real-world results, the aim is to investigate the long-term follow-up of nivolumab monotherapy for newly treated metastatic renal cell carcinoma. Methods A total of 121 patients were treated with nivolumab monotherapy as post-therapy after the failure of prior tyrosine kinase inhibitor therapy at four affiliated hospitals between January 2013 and December 2021. To determine the result after two years or more, we screened patients in whom nivolumab therapy was initiated in December 2019 or earlier because data collection was not completed before the end of December 2021. In 43 patients, Nivolumab was used as second-line therapy in 43 patients. In 38 patients, 38 of whom had treatment-related adverse events, including 33 who had immune-related adverse events, three of whom had treatment-related adverse events, including 33 who had immune-related adverse events. Conclusions The present real-world multi-institution study with long-term follow-up results shows that nivolumab monotherapy is safe for newly treated metastatic renal cell carcinoma, prolonging survival, improving tumor response, and has a manageable safety profile.
Source link: https://europepmc.org/article/MED/35373823
A CT scan revealed a 14-cm left renal mass and multiple lung and mediastinal lymph node metastases. Cellular carcinoma with 30% sarcomatoid features was discovered during a surgical open biopsy; histopathological examination revealed robust cellular carcinoma with 30% sarcomatoid characteristics. The patient was diagnosed with International Metastatic Renal Cell Carcinoma Database Consortium low-risk metastatic RCC with sarcomatoid characteristics, according to the researcher. She began receiving first-line systemic therapy.
Source link: https://europepmc.org/article/MED/35436063
Objectives This research sought to establish the role and prognostic importance of 18F-FDG PET/CT on treatment response and survival in metastatic renal cell carcinoma patients treated with immunotherapy or tyrosine kinase inhibitors. Patients and methods Forty patients with TKIs or PD-1 inhibitors were assessed by 18F-FDG PET/CT, according to the 18F-FDG PET/CT. Results in group-2 were as follows: PR in seven and SD in five patients, complete response in three patients, partial response in two patients, and stable disease in eight patients were recorded. The 5-year OS in patients with progressive disease was significantly shorter than those with clinical benefit, according to the researchers. 18F-FDG PET/CT can assist with patient care by examining the biological and immunological responses to therapy in patients treated with TKIs or ICIs.
Source link: https://europepmc.org/article/MED/35362692
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