Management of Patients With Metastatic Renal Cell Cancer and Bone Metastases

Nieder, Carsten; Dalhaug, Astrid; Pawinski, Adam

doi:10.21873/invivo.11822

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…and the high adherence to national guidelines in our institution and region (22,23), results are difficult to compare. In several of our own studies (4,5,(22)(23)(24), including the present one, we have so far not identified areas of concern regarding treatment access and efficacy in the framework of the publicly-funded healthcare system.…”

Section: Discussionmentioning

confidence: 82%

Survival and Early Death Within Three Months from the Start of Immune Checkpoint Inhibitors in Patients With Different Types of Cancer

2022

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Background/Aim: Implementation of new anti-cancer treatments in rural healthcare might not always result in identical survival outcomes as those seen in the randomized trials leading to approval. Therefore, the survival of patients treated with immune checkpoint inhibitors (ICI) in Nordland county was analyzed. Materials and Methods:Retrospective analysis of 199 patients, mainly treated in adjuvant or palliative settings, e.g. for non-small cell lung cancer (NSCLC) or malignant melanoma (2018)(2019)(2020)(2021).Overall survival and death within 3 months from start of ICI were evaluated. Results:All patients who received (neo)adjuvant treatment were alive at the time of this analysis. Median survival was not reached for patients treated with consolidation durvalumab for NSCLC. Twenty-five patients died within 3 months [none after (neo)adjuvant or consolidation ICI]. Among these 25 patients, none had performance status (PS) 0 and only 7 had PS 1. Among 13 patients aged ≥80 years, 5 (38%) died within 3 months. Four of five patients treated on an individual basis outside of generally accepted indications died within 3 months. Conclusion: The overall survival outcomes observed after limited follow-up appear satisfactory. Death within 3 months was typically caused by cancer progression and mostly related to reduced PS (≥2) and/or advanced age (≥80 years).

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Section: Discussionmentioning

confidence: 82%

Survival and Early Death Within Three Months from the Start of Immune Checkpoint Inhibitors in Patients With Different Types of Cancer

2022

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“…Nonetheless, the OS for a vast majority of patients continues to be restricted. [98] Recent advancements in image-guided ablation technologies have shown considerable promise in managing pain associated with osseous metastases. [27] In the study by Gardner et al, minimally invasive cryoablation could represent a viable treatment alternative for approximately 75% of BOM-RCC patients who are not candidates for surgical resection.…”

Section: The Site Of Rcc Metastasismentioning

confidence: 99%

Therapeutic options for different metastatic sites arising from renal cell carcinoma: A review

Wang,

Qian,

Qian

et al. 2024

Medicine

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Renal cell carcinoma (RCC) stands among the top 10 malignant neoplasms with the highest fatality rates. It exhibits pronounced heterogeneity and robust metastatic behavior. Patients with RCC may present with solitary or multiple metastatic lesions at various anatomical sites, and their prognoses are contingent upon the site of metastasis. When deliberating the optimal therapeutic approach for a patient, thorough evaluation of significant risk factors such as the feasibility of complete resection, the presence of oligometastases, and the patient’s functional and physical condition is imperative. Recognizing the nuanced differences in RCC metastasis to distinct organs proves advantageous in contemplating potential treatment modalities aimed at optimizing survival outcomes. Moreover, discerning the metastatic site holds promise for enhancing risk stratification in individuals with metastatic RCC. This review summarizes the recent data pertaining to the current status of different RCC metastatic sites and elucidates their role in informing clinical management strategies across diverse metastatic locales of RCC.

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“…The survival prognosis of these patients is heterogeneous, too. Pain might be present already as the first sign of cancer in patients expected to survive for several years, or in the pre-terminal and terminal phase when all systemic therapies have been stopped due to futility and/or the patients' reduced general condition (4)(5)(6)(7)(8). This heterogeneity causes uncertainty regarding treatment decisions, such as the decision to irradiate at all and the choice of fractionation regimen (9)(10)(11).…”

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confidence: 99%

Independent Validation of a Comprehensive Machine Learning Approach Predicting Survival After Radiotherapy for Bone Metastases

2021

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Background/Aim: The aim of this study was to analyze the survival predictions obtained from a web platform allowing for computation of the so-called Bone Metastases Ensemble Trees for Survival (BMETS). This prediction model is based on a machine learning approach and considers 27 prognostic covariates. Patients and Methods: This was a retrospective single-institution analysis of 326 patients, managed with palliative radiotherapy for bone metastases. Deviations between model-predicted survival and observed survival were assessed. Results: The median actuarial survival was 7.5 months. In total, 59% of patients survived for a period shorter than predicted. Twenty percent of the predictions of the median survival deviated from the observed survival by at least 6 months. Regarding actual survival <3 months (99 of 326 patients), the BMETS-predicted median survival was <3 months, i.e. correct in 67 of 99 cases (68%), whereas the model predicted a median of 4-6 months in 16 (16%) and of >6 months in another 16 cases. Conclusion: The model predicted survival with high accuracy in a large number of patients. Nevertheless, if the model predicts a low likelihood of 3-month survival, actual survival may be very poor (often 1 month or less). Also, in patients who died within 3 months from the start of radiotherapy, the model often predicted longer survival (16% had >6 months predicted median survival). It would, therefore, be interesting to feed the U.S. database utilized to develop the BMETS with additional poor-prognosis patients to optimize the predictions.

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Management of Patients With Metastatic Renal Cell Cancer and Bone Metastases

Abstract: Background/Aim: Previous research has ResultsBaseline characteristics. The majority of patients had clear cell histology (83%), male gender (77%), age between 60 and 69 years (74%), distant metastases at the time of initial 675 This article is freely accessible online.

Cited by 5 publications

References 23 publications

Survival and Early Death Within Three Months from the Start of Immune Checkpoint Inhibitors in Patients With Different Types of Cancer

Survival and Early Death Within Three Months from the Start of Immune Checkpoint Inhibitors in Patients With Different Types of Cancer

Therapeutic options for different metastatic sites arising from renal cell carcinoma: A review

Independent Validation of a Comprehensive Machine Learning Approach Predicting Survival After Radiotherapy for Bone Metastases

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