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Patients with metastatic renal cell carcinoma are highly dependent on disease surveillance based on radiological findings, which is directly related to drug therapy. The aim of the study was to compare non-standardized, common practice free text reporting on disease response with reporting based on response assessment criteria in solid tumors modified for immune-based therapeutics. In at least one follow-up examination, the tumor response or progression according to FTR were not confirmed with iRECIST in 19 or 11 patients, respectively, in at least one follow-up study. With FTR, new lesions were often not recognized if they were not already identified in the new prior examination odds ratio for a too high rate of disease response in comparison 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 indicates the need for standardized quantitative radiological analysis in daily clinical practice.
Source link: https://doi.org/10.1007/s00432-022-03997-0
According to previous studies, the gut microbiome influences the response to checkpoint inhibitors in cancer patients. 30 treatment-naive patients with apparent cell and/or sarcomatoid histology and intermediate- or poor-risk disease were randomized 2:1 to receive nivolumab and ipilimumab with or without daily oral CBM588, respectively, during this open-label, single-center study. Patients receiving nivolumab–ipilimumab with CBM588 were significantly longer than without — with a BBM588. With nivolumab–ipilimumab, the researchers suggest that CBM588 may enhance the clinical outcomes in patients with metastatic renal cell carcinoma treated with nivolumab–ipilimumab. A prospective clinical trial in treatment-naive patients with metastatic renal cell carcinoma shows that the addition of a live bacterium to an immunotherapy regimen provides promising clinical benefit in association with an enrichment of bacterial species, circulating cytokines, and immune cell populations in responders.
Source link: https://doi.org/10.1038/s41591-022-01694-6
Example inhibitors targeting c-MET expression such as cabozantinib may have improved patient management prior to systemic therapy, for example, receptors targeting c-METs such as cabozantinib. We present the first in-human results of 68Ga-EMP-100 in mRCC patients examining uptake characteristics in metastases and primary RCC. Standard uptake value and SUV-max measurements were compared to standard uptake value and SUV-max measurements. The highest uptake intensity was found at the primary site, followed by bone metastases, lymph nodes metastases, and visceral metastases, according to a study that looked at different tumor sites. The appearance of physically PET-negative lesions was distributed heterogeneously on a global and inter-individual basis; the largest number of PET-negative metastatic lesions were lung and liver metastases. Our first clinical findings point to further systemic studies looking into the use of 68Ga-EMP-100 as a biomarker in mRCC patients.
Source link: https://doi.org/10.1007/s00259-021-05596-6
Purpose – Objectives based on clinical findings The purpose of the adaptive dosing program in oncology with oral targeted therapies is largely based on clinical findings. By early monitoring of drug levels, using pharmacokinetics models to personalize dosing could save time, i. e. predicting clinical outcome by early monitoring of drug levels. Case report based on the following: We present the case of a metastatic renal cell carcinoma patient treated with standard Sunitinib dosing. Therapeutic Drug Monitoring found that the exposure was below the anticipated target level. Sunitinib dosing was then reduced to 62. 5 mg only, furthering drug exposure to the lower portion of the therapeutic window. Despite further research that suggested that Sunitinib dosing rises to 75 mg once more, the intermediate dosing was retained for the subsequent cycles to maintain the safety. This case suggests that model-based adaptive dosing may have enabled to achieve faster dosing with Sunitinib, possibly ensuring better patient care.
Source link: https://doi.org/10.1007/s00280-021-04383-2
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