Definitive radiotherapy in lieu of systemic therapy for oligometastatic renal cell carcinoma: a single-arm, single-centre, feasibility, phase 2 trial

Tang, Chad; Msaouel, Pavlos; Hara, Kieko; Choi, Haesun; Le, Venus; Shah, Amishi Yogesh; Wang, Jennifer; Jonasch, Eric; Choi, Seungtaek; Nguyen, Quynh‐Nhu; Das, Prajnan; Prajapati, Surendra; Yu, Zhiqian; Khan, Khaja; Powell, Steven; Murthy, Ravi; Sircar, Kanishka; Tannir, Nizar M.

doi:10.1016/s1470-2045(21)00528-3

Cited by 116 publications

(60 citation statements)

References 27 publications

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“…This study expands upon a recently reported phase 2 feasibility study of patients with oligometastatic RCC similarly treated with sequential SAbR [32]. Both studies sought to identify favorable patients and excluded patients with aggressive disease.…”

Section: Discussionmentioning

confidence: 82%

“…However, there are some important distinctions. The study by Tang et al [32] included both systemic therapy-naïve and on-treatment patients. These patient populations are, in our opinion, different, and we previously reported a study focusing on RCC patients with oligoprogressive disease-patients on systemic therapy with a limited number of progressive sites amenable to SAbR [33].…”

Section: Discussionmentioning

confidence: 99%

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Stereotactic Ablative Radiation for Systemic Therapy–naïve Oligometastatic Kidney Cancer

Hannan

Christensen

Christie

et al. 2022

European Urology Oncology

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Stereotactic Ablative Radiation for Systemic Therapy–naïve Oligometastatic Kidney Cancer

Hannan

Christensen

Christie

et al. 2022

European Urology Oncology

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“…However, the statistical regression model underlying the Assure nomogram did not include M1 NED status as a covariate [ 11 ]. For example, patients with metachronous RCC metastasis occurring many years after the nephrectomy and successfully treated with surgery or radiation therapy may have a lower probability of subsequent recurrence than patients whose solitary metastasis occurred early after nephrectomy [ 137 , 138 , 139 ]. None of the currently available prognostic algorithms or nomograms can discriminate between such scenarios.…”

Section: Clinical Scenariosmentioning

confidence: 99%

A Causal Framework for Making Individualized Treatment Decisions in Oncology

Msaouel

Lee

Karam

et al. 2022

Cancers

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We discuss how causal diagrams can be used by clinicians to make better individualized treatment decisions. Causal diagrams can distinguish between settings where clinical decisions can rely on a conventional additive regression model fit to data from a historical randomized clinical trial (RCT) to estimate treatment effects and settings where a different approach is needed. This may be because a new patient does not meet the RCT’s entry criteria, or a treatment’s effect is modified by biomarkers or other variables that act as mediators between treatment and outcome. In some settings, the problem can be addressed simply by including treatment–covariate interaction terms in the statistical regression model used to analyze the RCT dataset. However, if the RCT entry criteria exclude a new patient seen in the clinic, it may be necessary to combine the RCT data with external data from other RCTs, single-arm trials, or preclinical experiments evaluating biological treatment effects. For example, external data may show that treatment effects differ between histological subgroups not recorded in an RCT. A causal diagram may be used to decide whether external observational or experimental data should be obtained and combined with RCT data to compute statistical estimates for making individualized treatment decisions. We use adjuvant treatment of renal cell carcinoma as our motivating example to illustrate how to construct causal diagrams and apply them to guide clinical decisions.

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“…Thirty patients were enrolled, the median PFS was 22.7 months and no grade 3 complications were observed. The authors concluded that sequential RT could defer systemic therapy and allow for systemic therapy breaks in patients with oligo-persistent RCC [ 76 ] ( Table 4 ).…”

Section: Renal Cell Carcinomamentioning

confidence: 99%

Stereotactic Body Radiation Therapy in Patients with Oligometastatic Disease: Clinical State of the Art and Perspectives

Kinj

Muggeo

Schiappacasse

et al. 2022

Cancers

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Stereotactic body radiation therapy (SBRT) is a form of radiation therapy (RT) in which a small number of high doses of radiation are delivered to a target volume using highly sophisticated equipment. Stereotactic body radiation therapy is crucial in two cancer stages: early primary cancer and oligometastatic disease, with the goal of inducing complete cancer remission in both. This treatment method is commonly used to treat a variety of disease types. Over the years, a growing body of clinical evidence on the use of SBRT for the treatment of primary and metastatic tumors has accumulated, with efficacy and safety demonstrated in randomized clinical trials. This article will review the technical and clinical aspects of SBRT according to disease type and clinical indication.

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Definitive radiotherapy in lieu of systemic therapy for oligometastatic renal cell carcinoma: a single-arm, single-centre, feasibility, phase 2 trial

Cited by 116 publications

References 27 publications

Stereotactic Ablative Radiation for Systemic Therapy–naïve Oligometastatic Kidney Cancer

Stereotactic Ablative Radiation for Systemic Therapy–naïve Oligometastatic Kidney Cancer

A Causal Framework for Making Individualized Treatment Decisions in Oncology

Stereotactic Body Radiation Therapy in Patients with Oligometastatic Disease: Clinical State of the Art and Perspectives

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