Management of advanced kidney cancer: Canadian Kidney Cancer Forum (CKCF) consensus update 2017

North, Scott; Basappa, Naveen S.; Bjarnason, Georg A.; Blais, Normand; Canil, Christina; Heng, Daniel Y.C.; Knox, Jennifer J.; Ruether, Dean; Soulières, Denis; Zalewski, Paweł; Black, Peter C.; Breau, Rodney H.; Jewett, Michael A.S.; Lattouf, Jean‐Baptiste; Moore, R. D.; Rendon, Ricardo; Todd, Gerald; Pituskin, Edith; Gedye, Craig; Wood, Lori

doi:10.5489/cuaj.4769

Cited by 7 publications

(15 citation statements)

References 90 publications

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“…The death rate observed in our study was similar to that observed by Fall et al in Senegal with a mortality rate of 47%. [6] All genitourinary cancers, kidney cancer, in particular renal cell carcinoma (RCC), shows the rate of mortality highest [4]. These observations only confirm the derogatory nature of kidney cancer, which is considered to be the most lethal cancer in humans.…”

Section: Discussionmentioning

confidence: 99%

“…Therapeutically, radical or partial nephrectomy remains the standard treatment for renal cancer in adults in the localized stage. However, over the last ten years, significant therapeutic advances in the management of kidney cancer have been noted with the development of ablative treatments, partial nephrectomy and especially with the use of targeted therapies in locally advanced and metastatic forms [4]. The objective of this work was to study the epidemiological, diagnostic and therapeutic aspects of kidney tumors in adults over the past 5 years in our center.…”

Section: Introductionmentioning

confidence: 99%

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Kidney Tumors in Adult: Epidemiological, Clinical, Histopathological, Therapeutic and Progressive Aspects

Ndiaye¹,

Ndiath²,

Sine³

et al. 2020

IJCU

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Objective: To study the epidemiological, diagnostic and therapeutic profile of kidney tumors in adults over the past five years. Patients and methods: This was a retrospective, descriptive and analytical Study from the 1 st of January 2014 to 31 st of December 2018. All patients aged 18 years or older hospitalized, followed or operated in the service for a kidney tumor were included in the serie. The parameters studied were: epidemiological, clinical and paraclinical aspects, TNM stage (2017), treatment, histological type, evolution and survival. The calculation of survival rate was done with SPSS IBM statistics 24. Results: sixty-seven patients were included. The average annual incidence was 13. The average age of the patients was 49.6±15.6 years. The sex-ratio was 1.2. Hypertension, smoking and obesity were the main risk factors found. The average size of the tumor was 7.7±4.40 cm. The left kidney location was more frequent. Thirteen patients (20%) had a localized tumor in the kidney, twenty patients (31%) had locally advanced cancer and thirty two patients (49%) had metastasized cancer. Forty-seven patients (70%) had surgical treatment, including five patients with an anti-angiogenic adjuvant therapy. Twelve (17.9%) patients had an antiangiogenic therapy only. Clear cell carcinoma was the most common histology type. The overall survival (OS) rate for cancer patients at 2 years was 22% for surgical treatment, 8% for medical treatment. Conclusion: this work reveals that adult kidney cancer affects young adult and is discovered at advanced stages without any significant change in the epidemiological and clinical profile of these cancers during the two decades.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Kidney Tumors in Adult: Epidemiological, Clinical, Histopathological, Therapeutic and Progressive Aspects

Ndiaye¹,

Ndiath²,

Sine³

et al. 2020

IJCU

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“…51 Although mRCC has entered the immune checkpoint inhibitor era, the set of six IMDC criteria (hemoglobin less than the lower limit of normal, corrected calcium greater than the upper limit of normal (ULN), platelets greater than the ULN, neutrophils greater than the ULN, Karnofsky performance status less than 80%, and time from diagnosis to treatment of less than one year) remains the recommended tool for patient counselling, treatment selection (e.g., initial observation, systemic therapy, cytoreductive nephrectomy), and future research studies. These IMDC criteria stratify patients with mRCC into 3 risk groups based on their score: favorable (0), intermediate (1-2), or poor (3)(4)(5)(6). It should be emphasized that the IMDC classification is a prognostic classification and not a predictive tool.…”

Section: Risk-stratificationmentioning

confidence: 99%

“…For more than a decade, targeted systemic therapies have been the standard of care for metastatic renal cell carcinoma (mRCC) and their use has been refined over time as clinical experience has evolved. [1][2][3][4][5][6] The 2019 consensus statement by the Kidney Cancer Research Network of Canada (KCRNC) introduced the role of immunotherapy as first-line systemic therapy for mRCC, either as doublet immunotherapy or in combination with a vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI), based on phase 3 studies that demonstrated improved survival compared to single-agent VEGFR-TKI (sunitinib). [7][8][9] Subsequently, there have been updates on two of the important previously report-ed phase 3 studies (CheckMate 214 and Keynote-426) that have reinforced prior results.…”

Section: Introductionmentioning

confidence: 99%

Management of advanced kidney cancer: Kidney Cancer Research Network of Canada (KCRNC) consensus update 2021

Canil¹,

Kapoor²,

Basappa³

et al. 2021

CUAJ

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To answer the multiple-choice questions associated with this article, go to: www.cuasection3credits.org/cuajapril2021. This program is an Accredited Self-Assess-ment Program (Section 3) as defined by the Maintenance of Certification Program of The Royal College of Physicians & Surgeons of Canada, and approved by the Canadian Urological Association. Remember to visit MAINPORT (www.mainport.org/mainport/) to record your learning and outcomes. You may claim a maximum of 1 hour of credit.

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“…Cytoreductive “debulking” surgery has long been considered a standard of care for eligible patients with metastatic renal cell carcinoma and is still widely recommended for selected patients 1,2 . This recommandation relies on many retrospective data and on two prospective clinical trials showing an improved overall survival in patients undergoing nephrectomy before receiving Interferon therapy 3,4 .…”

Section: Introductionmentioning

confidence: 99%

A rationale for surgical debulking to improve anti-PD1 therapy outcome in non small cell lung cancer

Guisier

Cousse

Jeanvoine

et al. 2019

Sci Rep

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Anti-PD1 immunotherapy has emerged as a gold-standard treatment for first- or second-line treatment of stage IV NSCLC, with response rates ranging from 10 to 60%. Strategies to improve the disease control rate are needed. Several reports suggested that debulking surgery enhances anti-tumor immunity. We aimed at examining tumor burden as a predictive factor of anti-PD1 tretment efficacy and to evaluate the role of cytoreductive surgery in anti-PD1 treated NSCLC. Immunocompetent DBA/2 mice engrafted with various amount of allogeneic lung squamous cancer KLN-205 cells were treated with anti-PD1 monoclonal antibody. Mice engrafted with two tumors also underwent a debulking surgery or a sham procedure. Tumor volume was monitored to assess treatment efficacy. Tumor infiltrating lymphocytes were assessed by flow cytometry. In a retrospective study of 48 stage IV NSCLC patients treated with Nivolumab who underwent a 18-FDG PETscan before treatment onset, the prognostic role of metabolic tumor volume was analysed. Anti-PD1 treatment effect was greater in mice bearing smaller tumors. Treatment with higher doses of anti-PD1 antibody did not improve the outcome, independently of the size of the tumor. In mice bearing 2 tumors, excision of 1 tumor improved the anti-PD1 treatment effect on the remaining tumor. In 48 NSCLC patients receiving anti-PD1 treatment, high metabolic tumor volume was associated with poor overall survival and the absence of clinical benefit. Treg infiltration, but not effector T cells, was positively correlated to tumor volume. Taken together, our results suggest that tumor volume is a predictive factor of anti-PD1 efficacy in NSCLC. Additionally, an experimental murine model suggests that tumor debulking may improve control of residual tumor.

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Management of advanced kidney cancer: Canadian Kidney Cancer Forum (CKCF) consensus update 2017

Abstract: N/A

Cited by 7 publications

References 90 publications

Kidney Tumors in Adult: Epidemiological, Clinical, Histopathological, Therapeutic and Progressive Aspects

Kidney Tumors in Adult: Epidemiological, Clinical, Histopathological, Therapeutic and Progressive Aspects

Management of advanced kidney cancer: Kidney Cancer Research Network of Canada (KCRNC) consensus update 2021

A rationale for surgical debulking to improve anti-PD1 therapy outcome in non small cell lung cancer

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