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Kidney Cancer
Immunotherapy

COSMIC-313: Triplet Therapy Is Active in Renal Cell Carcinoma, but Toxicities Pose a Challenge

The addition of cabozantinib to nivolumab plus ipilimumab prolonged progression-free survival in untreated intermediate-risk patients with advanced renal cell carcinoma (RCC), according to the first results of the phase III COSMIC-313 trial. These findings were presented as a Presidential Symposium ...

Kidney Cancer

Minimally Invasive vs Open Nephrectomy for Kidney Cancer: 1-Year Health-Care Expenditure and Utilization

In a retrospective cohort study reported in JAMA Network Open, Okhawere et al found that minimally invasive surgery was associated with similar or reduced total expenditures vs open surgery during the first year after partial or radical nephrectomy for kidney cancer. Study Details The study...

kidney cancer

Treatment of Non–Clear Cell RCC

This is Part 4 of Updates in Renal Cell Carcinoma, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Wenxin (Vincent) Xu, David Braun, and Bradley McGregor discuss the treatment of non–clear cell renal cell carcinoma (RCC). The patient is a 54-year-old woman who is diagnosed with metastatic papillary RCC after biopsy of the adrenal gland. The faculty discuss the critical importance of providing histology-directed therapy for all patients with non–clear cell RCC and variant histology, reviewing recent clinical trial data in papillary RCC and chromophobe RCC.   Editor’s Note: This discussion was filmed prior to the ESMO Congress 2022.

kidney cancer

Adjuvant Therapy in RCC

This is Part 3 of Updates in Renal Cell Carcinoma, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Wenxin (Vincent) Xu, David Braun, and Bradley McGregor discuss the role of adjuvant therapy in renal cell carcinoma (RCC). The patient is a 45-year-old man with a 7.2-cm, pT3aN0 clear cell RCC, grade 2, extending into the renal vein. He is treated with surgery and is back to his baseline level of health. The faculty discuss the next steps for a patient such as this, debating whether he should receive adjuvant sunitinib, adjuvant pembrolizumab, or imaging surveillance alone. They review the results of recent immune checkpoint inhibitor studies in RCC, highlighting the growing role of adjuvant pembrolizumab in this setting. Editor’s Note: This discussion was filmed prior to the ESMO Congress 2022.

kidney cancer

Second-Line Therapy and Beyond in Clear Cell RCC

This is Part 2 of Updates in Renal Cell Carcinoma, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Wenxin (Vincent) Xu, David Braun, and Bradley McGregor discuss second-line therapy and beyond in clear cell renal cell carcinoma (RCC). The patient is a 63-year-old man with clear cell RCC metastatic to bilateral lungs with multistation lymphadenopathy. He had initial partial response to pazopanib but now has progression of disease in multifocal lung nodules. The faculty discuss the vast treatment armamentarium for RCC in the second- and third-line settings, as well as the role for immunotherapy re-challenge in those patients who experience disease progression after immune checkpoint inhibition.   Editor’s Note: This discussion was filmed prior to the ESMO Congress 2022.

kidney cancer

First-Line Therapy in Metastatic Clear Cell RCC

This is Part 1 of Updates in Renal Cell Carcinoma, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Wenxin (Vincent) Xu, David Braun, and Bradley McGregor discuss first-line therapy in metastatic clear cell renal cell carcinoma (RCC). The patient is a 62-year-old woman with metastatic clear cell RCC, with a 10-cm left renal mass and active metastases in the bone, lung, and brain. She undergoes stereotactic body radiotherapy to the brain, which is tolerated well, and inquires about next steps for treatment. The faculty discuss how best to stratify patients based on IMDC risk factor criteria and review important patient factors—such as preexisting immune and cardiovascular conditions—to consider when deciding on treatment plans. In addition, they review the role of cytoreductive nephrectomy, checkpoint inhibitor combinations, and the potential role of triplet therapy.     Editor’s Note: This discussion was filmed prior to the ESMO Congress 2022.

kidney cancer

Nizar M. Tannir, MD, on RCC: Data on Bempegaldesleukin Plus Nivolumab vs Tyrosine Kinase Inhibitors in Untreated Disease

Nizar M. Tannir, MD, of The University of Texas MD Anderson Cancer Center, discusses phase III findings from the PIVOT-09 study, which compared bempegaldesleukin plus nivolumab with the investigator’s choice of a tyrosine kinase inhibitor (either sunitinib or cabozantinib) in patients with previously untreated advanced renal cell carcinoma (Abstract LBA68).

Kidney Cancer
Immunotherapy

Adjuvant Atezolizumab Does Not Improve Disease-Free Survival in Patients With RCC

Adjuvant therapy with the anti–PD-L1 therapy atezolizumab failed to improve disease-free survival compared to placebo in patients with renal cell carcinoma (RCC) at high risk of recurrence after resection, according to results of the phase III IMmotion010 trial presented by Axel Bex, MD, PhD, at...

kidney cancer
immunotherapy

Toni K. Choueiri, MD, and Laurence Albiges, MD, PhD, on RCC: Recent Phase III Data on Cabozantinib, Nivolumab, and Ipilimumab From the COSMIC-313 Trial

Toni K. Choueiri, MD, of the Dana-Farber Cancer Institute, and Laurence Albiges, MD, PhD, of France’s Gustave Roussy Cancer Centre, discuss phase III findings showing that cabozantinib in combination with nivolumab and ipilimumab reduced the risk of disease progression or death compared with the combination of nivolumab plus ipilimumab in patients with previously untreated advanced renal cell carcinoma of IMDC (the International Metastatic RCC Database Consortium) intermediate or poor risk. However, the combination of cabozantinib, nivolumab, and ipilimumab vs nivolumab plus ipilimumab did not demonstrate an overall survival benefit to patients (Abstract LBA8).

kidney cancer
immunotherapy

Axel Bex, MD, PhD, on Renal Cell Carcinoma: Phase III Results With Atezolizumab as Adjuvant Therapy

Axel Bex, MD, PhD, of the Netherlands Cancer Institute, discusses phase III findings from the IMmotion010 study, which evaluated the efficacy and safety of atezolizumab vs placebo in patients with renal cell cancer who are at high risk of disease recurrence following nephrectomy (Abstract LBA66).

kidney cancer

Toni K. Choueiri, MD, and Laurence Albiges, MD, PhD, on RCC: Review of Two Key Abstracts on Belzutifan Plus Cabozantinib and Pembrolizumab Plus Lenvatinib

Toni K. Choueiri, MD, of the Dana-Farber Cancer Institute, and Laurence Albiges, MD, PhD, of France’s Gustave Roussy Cancer Centre, discuss results from two important trials presented at ESMO 2022: Cohort 1 of the LITESPARK-003 study of belzutifan plus cabozantinib as first-line treatment of advanced renal cell carcinoma (RCC), and the KEYNOTE-B61 study of pembrolizumab plus lenvatinib as first-line treatment for non–clear cell RCC (Abstracts 1447O and 1448O).

Kidney Cancer
Immunotherapy

COSMIC-313: Cabozantinib, Nivolumab, and Ipilimumab in Previously Untreated Patients With Advanced Renal Cell Carcinoma

A targeted kinase inhibitor added to a two-drug immunotherapy combination slowed the progression of advanced kidney cancer in previously untreated patients, according to research led by Toni K. Choueiri, MD. Dr. Choueiri, who is the Director of the Lank Center for Genitourinary Cancer at...

Kidney Cancer
Immunotherapy

PROSPER RCC: Neoadjuvant Nivolumab Prior to Nephrectomy Followed by Additional Nivolumab in Patients With Renal Cell Carcinoma

The ECOG-ACRIN Cancer Research Group presented data from PROSPER RCC (EA8143), the first randomized phase III trial of neoadjuvant immunotherapy in patients with kidney cancer, at the European Society for Medical Oncology (ESMO) Congress 2022 (Abstract LBA67). Patients with high-risk renal cell...

Kidney Cancer
Immunotherapy

Adjuvant Pembrolizumab in Patients With Clear Cell Renal Cell Carcinoma and Increased Risk of Recurrence: 30-Month Follow-up of KEYNOTE-564

As reported in The Lancet Oncology by Thomas Powles, MD, PhD, and colleagues, the 30-month follow-up of the phase III KEYNOTE-564 trial showed a continued disease-free survival benefit with adjuvant pembrolizumab vs placebo in patients with clear cell renal cell carcinoma who are at increased risk...

Kidney Cancer

Addition of Telaglenastat to Cabozantinib in Previously Treated Patients With Metastatic Renal Cell Carcinoma

As reported in JAMA Oncology by Nizar M. Tannir, MD, FACP, and colleagues, the phase II CANTATA trial showed no improvement in progression-free survival with the addition of the glutaminase inhibitor telaglenastat to cabozantinib in previously treated patients with metastatic clear cell renal cell...

Kidney Cancer

ASCO Releases First Comprehensive Evidence-Based Guidelines for Metastatic Clear Cell Renal Cell Carcinoma

ASCO has released the first comprehensive set of guidelines for the management of metastatic clear cell renal cell carcinoma (RCC).1 The guidelines are subdivided into six main sections: diagnosis, the role of cytoreductive nephrectomy, first-line systemic treatment, second- or later-line systemic...

Kidney Cancer

Adjuvant Everolimus Narrowly Misses Statistical Significance in RCC, Except for Very High–Risk Patients

In the phase III EVEREST trial, adjuvant everolimus improved median recurrence-free survival in patients with resected renal cell carcinoma (RCC), but this finding failed to be statistically significant in the total study population of 1,499 patients, according to a prespecified boundary. However,...

Kidney Cancer
Immunotherapy

Nivolumab/Cabozantinib vs Sunitinib in First-Line Treatment for Advanced RCC: Overall Survival Analysis of CheckMate 9ER Trial

As reported in The Lancet Oncology by Robert J. Motzer, MD, and colleagues, the protocol-defined final overall survival analysis of the phase III CheckMate 9ER trial showed a significant benefit with nivolumab/cabozantinib vs sunitinib in previously untreated patients with advanced renal cell...

Kidney Cancer
Immunotherapy

Longitudinal Liquid Biopsy for Circulating Tumor Cells in Metastatic Renal Cell Carcinoma

In a study reported in the Journal of Clinical Oncology, Bootsma et al found that higher circulating tumor cell (CTC) enumeration trajectory identified through longitudinal liquid biopsy was associated with poorer survival in patients receiving immune checkpoint inhibitor treatment for metastatic...

kidney cancer
immunotherapy

Jonathan E. Rosenberg, MD, and Thomas Powles, MD, PhD, on Renal Cell Carcinoma: New Data on Pembrolizumab Plus Axitinib vs Sunitinib as First-Line Therapy

Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, and Thomas Powles, MD, PhD, of Barts Health NHS Trust, Queen Mary University of London, discuss phase III findings from the KEYNOTE-426 trial, which appear to support the long-term benefit of pembrolizumab plus axitinib for first-line treatment of patients with advanced clear cell renal cell carcinoma (Abstract 4513).

Kidney Cancer

Researchers Examine Racial Differences in Treatment and Outcomes of First-Line Therapies for Kidney Cancer

Black and White patients treated with similar first-line therapies for advanced kidney cancer experienced similar outcomes, but different response rates, according to research from Fox Chase Cancer Center presented by Daniel Geynisman, MD, at the 2022 ASCO Annual Meeting (Abstract 4548). “This was...

Kidney Cancer

Analysis of Circulating Tumor DNA as a Biomarker in Stage III or IV Wilms Tumor

In an analysis from a Children’s Oncology Group trial (AREN0533) reported in the Journal of Clinical Oncology, Madanat-Harjuoja et al found that the analysis of circulating tumor DNA (ctDNA) in children with stage III or IV Wilms tumor demonstrated high levels of agreement in identifying risk...

Kidney Cancer
Immunotherapy

Nivolumab and Salvage Nivolumab/Ipilimumab for Previously Untreated Advanced Clear Cell Renal Cell Carcinoma

In a phase II trial (Hoosier Cancer Research Network GU16-260) reported in the Journal of Clinical Oncology, Michael B. Atkins, MD, and colleagues found that nivolumab monotherapy was active in previously untreated patients with advanced clear cell renal carcinoma, particularly among those with...

Kidney Cancer
Immunotherapy

Lenvatinib/Pembrolizumab vs Sunitinib in Patients With Advanced Renal Cell Carcinoma: Health-Related Quality-of-Life Outcomes

In a study reported in The Lancet Oncology, Robert Motzer, MD, and colleagues found that patients with previously untreated advanced renal cell carcinoma receiving lenvatinib/pembrolizumab had similar or favorable health-related quality of life scores and prolonged time to definitive deterioration...

Kidney Cancer
Immunotherapy

Biomarker-Driven Assessment of Nivolumab, Nivolumab/Ipilimumab, and VEGFR Tyrosine Kinase Inhibitors in First-Line Treatment of Metastatic Clear Cell RCC

In the French phase II BIONIKK trial reported in The Lancet Oncology, Vano et al assessed outcomes of first-line treatment with nivolumab with or without ipilimumab and VEGFR tyrosine kinase inhibitors given according to characteristics of molecular subgroups in patients with metastatic clear cell...

Kidney Cancer

Deciphering Clinical Outcomes Through Molecular Profiling: The IMmotion151 Trial

Over the past decade, an improved understanding of kidney cancer biology together with the development of novel systemic therapies have substantially improved the outcomes of patients with metastatic clear cell renal cell carcinoma (RCC).1 Following extensive clinical investigations, combinations...

Kidney Cancer

No Overall Survival Benefit With Atezolizumab Plus Bevacizumab vs Sunitinib in Previously Untreated Metastatic Renal Cell Carcinoma

As reported in JAMA Oncology by Robert J. Motzer, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the final overall survival analysis of the phase III IMmotion151 trial has shown no significant difference for the PD-L1 inhibitor atezolizumab plus bevacizumab vs sunitinib in patients ...

Kidney Cancer
Immunotherapy

Several Studies Evaluate Agents in the First-Line, Second-Line, and Later Treatment of Advanced Kidney Cancer

The combination of nivolumab plus cabozantinib achieved a continued survival benefit compared with sunitinib in patients with untreated clear cell metastatic or advanced renal cell carcinoma, according to a final overall survival analysis of the phase III CheckMate 9ER trial.1 Additionally,...

Kidney Cancer
Immunotherapy

Cabozantinib Plus Nivolumab in Advanced Non–Clear Cell Renal Cell Carcinoma

In a single-institution phase II study reported in the Journal of Clinical Oncology, Chung-Han Lee, MD, PhD, and colleagues found that the combination of cabozantinib and nivolumab was active in patients with advanced non–clear cell renal cell carcinoma (RCC) variants, particularly those with...

Kidney Cancer
Immunotherapy

KEYNOTE-564 Update Supports Benefit of Adjuvant Pembrolizumab in High-Risk Renal Cell Carcinoma

An updated analysis of the phase III KEYNOTE-564 trial continues to support the use of adjuvant pembrolizumab vs placebo in patients with renal cell carcinoma at high risk of recurrence, according to a presentation at the 2022 ASCO Genitourinary Cancers Symposium.1 At 30 months of follow-up,...

Kidney Cancer

CheckMate 9ER: Final Results Support First-Line Regimen of Nivolumab Plus Cabozantinib in Advanced Kidney Cancer

The combination of nivolumab plus cabozantinib achieved a continued survival benefit compared with sunitinib in patients with untreated clear cell metastatic or advanced renal cell carcinoma, according to a final overall survival analysis of the phase III CheckMate 9ER trial.1 Additionally,...

Bladder Cancer
Kidney Cancer
Prostate Cancer
Immunotherapy

Genitourinary Oncology 2021–2022 Almanac

The past year has witnessed tremendous advances in genitourinary oncology. I am pleased to review these findings in this year’s Genitourinary Oncology Almanac from The ASCO Post. I hope that you will find this roadmap helpful in highlighting a selection of these exciting developments. Checkpoint...

Kidney Cancer
Immunotherapy

KEYNOTE-564 Update Supports Benefit of Adjuvant Pembrolizumab in High-Risk Renal Cell Carcinoma

An updated analysis of the phase III KEYNOTE-564 trial continues to support the use of adjuvant pembrolizumab vs placebo in patients with renal cell carcinoma at high risk of recurrence, according to a presentation at the 2022 ASCO Genitourinary Cancers Symposium.1 At 30 months of follow-up,...

Kidney Cancer
Immunotherapy

KEYNOTE-564: Adjuvant Pembrolizumab Extends Disease-Free Survival in High-Risk Renal Cell Carcinoma

Adjuvant pembrolizumab following surgery significantly improved disease-free survival compared with placebo among patients with high-risk clear cell renal cell carcinoma (RCC), according to the international phase III KEYNOTE-564 study presented at the Plenary session during the 2021 ASCO Annual...

Kidney Cancer
Immunotherapy

First-Line Nivolumab Plus Cabozantinib Improves Progression-Free and Overall Survival vs Sunitinib in Advanced Renal Cell Carcinoma

As reported in The New England Journal of Medicine by Toni K. Choueiri, MD, of Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, and colleagues, the phase III CheckMate 9ER trial has shown that the combination of nivolumab and cabozantinib improved progression-free survival and...

kidney cancer
bladder cancer
prostate cancer
genomics/genetics
immunotherapy
covid-19

Sumanta K. Pal, MD, on Advances in Genitourinary Cancer Treatment: Expert Perspective

Sumanta K. Pal, MD, of City of Hope National Medical Center, discusses some key research developments in kidney cancer, including data on nivolumab and ipilimumab with or without CBM588 in metastatic renal cell carcinoma; intestinal microbiome associated with the development of grade 3 or 4 adverse events in patients with metastatic disease who have been treated with nivolumab plus ipilimumab and probiotic support; the link between TERT promoter mutations and clinical outcome with immune checkpoint inhibitor therapy for advanced urothelial cancer; mutations in the androgen receptor gene in patients with prostate cancer receiving novel androgen deprivation treatments; and findings on waning antibody titers in patients who have received COVID-19 vaccinations (Roundup of Abstracts 371, 561, 374, Posters 38 and 48).

Kidney Cancer
Immunotherapy

KEYNOTE-564 Update Supports Benefit of Adjuvant Pembrolizumab in High-Risk Renal Cell Carcinoma

An updated analysis of the phase III KEYNOTE-564 trial continues to support the use of adjuvant pembrolizumab vs placebo in patients with renal cell carcinoma at high risk of recurrence, according to a presentation at the 2022 ASCO Genitourinary Cancers Symposium.1 At 30 months of follow-up,...

kidney cancer
immunotherapy

Toni K. Choueiri, MD, on Renal Cell Carcinoma: Follow-up Data on Pembrolizumab

Toni K. Choueiri, MD, of Dana-Farber Cancer Institute, discusses a 30-month follow-up of results from the KEYNOTE-564 trial, which further support the use of adjuvant pembrolizumab when treating patients with renal cell carcinoma at intermediate-high or high risk of recurrence, or with an M1 NED (no evidence of disease) status after nephrectomy. The data show a disease-free survival benefit vs placebo (Abstract 290).

Kidney Cancer

Risk of Major Adverse Cardiovascular Events With Combined Immune Checkpoint Inhibition and VEGFR Inhibition in Patients With Advanced RCC

As reported in the Journal of Clinical Oncology by Brian I. Rini, MD, and colleagues, prospective cardiovascular monitoring in the phase III JAVELIN Renal 101 trial in advanced renal cell carcinoma (RCC) showed that patients with higher baseline troponin T levels receiving the combination of the...

Kidney Cancer

(Epi)genetic Predisposing Factors in Wilms Tumor

In a Dutch study reported in the Journal of Clinical Oncology, Janna A. Hol, MD, and colleagues found that (epi)genetic predisposing factors could be identified in one-third of children diagnosed with Wilms tumor. As stated by the investigators, “Wilms tumor is associated with (epi)genetic...

issues in oncology
bladder cancer
kidney cancer
prostate cancer

Karen E. Knudsen, PhD, MBA, on Addressing Disparities in Genitourinary Cancers

Karen E. Knudsen, PhD, MBA, Chief Executive Officer of the American Cancer Society, discusses ways to address the inequities in genitourinary screening, treatment, and outcomes. Her suggestions focus on increasing awareness of screening, identifying risk factors, the dramatic rise in incidence among Hispanic individuals, and the basis for increased mortality in Black men.

Bladder Cancer
Kidney Cancer
Prostate Cancer

Minority Enrollment in U.S. Phase II and III Trials in Genitourinary Cancers

In a study reported in the Journal of Clinical Oncology, Owens-Walton et al found that minority populations are underrepresented in phase II and III trials targeting prostate, kidney, and bladder cancers taking place in the United States. Study Details In the analysis, the ClinicalTrials.gov...

kidney cancer
immunotherapy

Axel Bex, MD, PhD, on Renal Cell Carcinoma: New Findings From the NeoAvAx Trial on Avelumab and Axitinib

Axel Bex, MD, PhD, of The Netherlands Cancer Institute, discusses an efficacy, safety, and biomarker analysis of neoadjuvant avelumab and axitinib in patients with localized renal cell carcinoma who are at high risk of relapse after nephrectomy (Abstract 289).

kidney cancer
immunotherapy

Matthew R. Zibelman, MD, on Renal Cell Carcinoma: New Results on Combination of Nivolumab and Axitinib

Matthew R. Zibelman, MD, of Fox Chase Cancer Center, discusses phase I/II results from a study of treatment-naive patients with advanced renal cell carcinoma who received a combination of the immunotherapy (IO) nivolumab and the tyrosine kinase inhibitor (TKI) axitinib. The findings suggest that the efficacy of this regimen is comparable to that of currently available IO/TKI combinations for this population and has a similar safety profile (Abstract 291).

Kidney Cancer
Immunotherapy

First-Line Nivolumab/Cabozantinib vs Sunitinib for Advanced Renal Cell Carcinoma: Patient-Reported Outcomes

In an analysis from the phase III CheckMate 9ER trial reported in The Lancet Oncology, David Cella, PhD, FASCO, and colleagues found that nivolumab/cabozantinib was associated with maintained or improved patient-reported outcomes vs sunitinib in the first-line treatment of advanced renal cell...

Kidney Cancer
Immunotherapy

Atezolizumab/Bevacizumab vs Sunitinib in Previously Untreated Patients With Metastatic RCC: Final Overall Survival Analysis of IMmotion151

As reported in JAMA Oncology by Robert J. Motzer, MD, and colleagues, the final overall survival analysis of the phase III IMmotion151 trial has shown no significant difference for atezolizumab plus bevacizumab vs sunitinib in previously untreated patients with metastatic renal cell carcinoma...

Kidney Cancer

Stereotactic Radiation May Prolong Duration of Systemic Therapy for Metastatic Kidney Cancer

A new study published by Hannan et al in European Urology Oncology showed that highly focused radiation to isolated metastases that progress despite drug therapy may prolong drug efficacy in patients with kidney cancer. Together with a Canadian report recently published by Cheung et al in European...

Kidney Cancer

Pembrolizumab for Adjuvant Treatment of Renal Cell Carcinoma

On November 17, 2021, the immunotherapeutic agent pembrolizumab was granted approval for adjuvant treatment of patients with renal cell carcinoma at intermediate-high or high risk of recurrence following nephrectomy or nephrectomy and resection of metastatic lesions.1 Supporting Efficacy Data...

Kidney Cancer

Belzutifan Shows Activity in Patients With von Hippel-Lindau Disease–Associated Renal Cell Carcinoma

In the phase II MK-6482-004 trial reported in The New England Journal of Medicine, Eric Jonasch, MD, and colleagues found that the hypoxia-inducible factor (HIF)-2α inhibitor belzutifan produced responses in patients with renal cell carcinoma (RCC) associated with von Hippel-Lindau disease....

Kidney Cancer
Immunotherapy

Adjuvant Immunotherapy: The Next Chapter in Advancements in Renal Cell Carcinoma

Renal cell carcinoma is a common malignancy among men and women in the United States.1 The incidence continues to increase with the ever-increasing use of contemporary medical imaging. Although many patients who present with localized disease are cured with definitive surgery, some patients develop ...

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