Trends in Renal-Cell Carcinoma Incidence and Mortality in the United States in the Last 2 Decades: A SEER-Based Study

Saad, Anas M.; Gad, Mohamed M.; Al‐Husseini, Muneer J.; Ruhban, Inas A.; Sonbol, Mohamad Bassam; Ho, Thai H.

doi:10.1016/j.clgc.2018.10.002

Cited by 156 publications

(128 citation statements)

References 45 publications

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“…15 Because one-half of RCC cases in the United States are diagnosed in individuals aged 65 years or older 16 and because older patients are underrepresented in clinical trials, 17,18 we focused our analysis on the population enrolled in Medicare. Furthermore, because up to one-third of patients present with metastatic disease, 19,20 we focused on patients whose initial diagnosis was metastatic RCC (mRCC).…”

Section: Introductionmentioning

confidence: 99%

Comparative Survival Associated With Use of Targeted vs Nontargeted Therapy in Medicare Patients With Metastatic Renal Cell Carcinoma

Jahnke

Pettit

et al. 2019

JAMA Netw Open

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IMPORTANCE Targeted therapies for advanced renal cell carcinoma (RCC) have shown increased tolerability and survival advantages over older treatments in clinical trials, but understanding of realworld survival improvements is still emerging. OBJECTIVE To compare overall and RCC-specific survival associated with use of targeted vs nontargeted therapy for metastatic RCC. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used Surveillance, Epidemiology, and End Results-Medicare data from 2000 to 2013 to examine patients with stage IV (distant) clear cell RCC at the time of diagnosis who received any targeted or nontargeted therapy. A 2-stage residual inclusion model was fitted to estimate the survival advantages of targeted treatments using an instrumental variable approach to account for both measured and unmeasured group differences. Data analyses were conducted from July 24, 2017, to April 4, 2019. EXPOSURES Targeted therapy (study group) or nontargeted therapy (control group). MAIN OUTCOMES AND MEASURES Overall survival and RCC-specific survival, defined as the interval between the date of first drug treatment and date of death or end of the observation period. RESULTS The final sample included 1015 patients (mean [SD] age, 71.2 [8.1] years; 392 [39%] women); 374 (37%) received nontargeted therapy and 641 (63%) received targeted therapy. The targeted therapy group had a greater percentage of disabled patients (ie, those <65 years old who were eligible for Medicare because of disability) and older patients (ie, those Ն75 years old) and higher comorbidity index and disability scores compared with the nontargeted therapy group. Unadjusted Kaplan-Meier survival curves showed higher overall survival for targeted vs nontargeted therapy (log-rank test, χ 2 1 = 5.79; P = .02); median survival was not statistically significantly different (8.7 months [95% CI, 7.3-10.2 months] vs 7.2 months [95% CI, 5.8-8.8 months]; P = .14). According to the instrumental variable analysis, the median overall survival advantage was 3.0 months (95% CI, 0.7-5.3 months), and overall survival improvements associated with targeted therapy vs nontargeted therapy were statistically significant: 8% at 1 year (44% [95% CI, 39%-50%] vs 36% [95% CI, 30%-42%]; P = .01), 7% at 2 years (25% [95% CI, 20%-30%] vs 18% [95% CI, 13%-23%]; P = .009), and 5% at 3 years (15% [95% CI, 11%-19%] vs 10% [95% CI, 6%-13%]; P = .01). Receipt of targeted therapy was associated with a lower hazard of death compared with nontargeted therapy (overall survival hazard ratio, 0.78 [95% CI, 0.65-0.94]; RCC-specific survival hazard ratio, 0.77 [95% CI, 0.62-0.96]).

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Section: Introductionmentioning

confidence: 99%

Comparative Survival Associated With Use of Targeted vs Nontargeted Therapy in Medicare Patients With Metastatic Renal Cell Carcinoma

Jahnke

Pettit

et al. 2019

JAMA Netw Open

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“…ccRCC is the most common type of renal cell carcinoma arising from epithelial cells of the proximal tubule of the kidney, comprising more than 70% of all renal cancers (1). ccRCC represents an immune sensitive tumor type well known for early advances in systemic immunotherapy using T cell proliferation cytokine IL-2 and interferon-α2b therapy (2).…”

Section: Introductionmentioning

confidence: 99%

Mapping the Immune Landscape of Clear Cell Renal Cell Carcinoma by Single-Cell RNA-seq

Vishwakarma

Borcherding

Chimenti

et al. 2019

Preprint

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One Sentence Summary: Single-cell RNA-sequencing reveals unique lymphoid and myeloid gene programs with putative functions in clear cell renal cancer patients Abstract: The immune cells within the tumor microenvironment are considered key determinants of response to cancer immunotherapy. Immune checkpoint blockade (ICB) has transformed the treatment of clear cell renal cell carcinoma (ccRCC), although the role of specific immune cell states remains unclear. To characterize the tumor microenvironment (TME) of ccRCC, we applied single-cell RNA sequencing (scRNA-seq) along with paired T cell receptor sequencing to map the transcriptomic heterogeneity of 24,904 individual CD45 + lymphoid and myeloid cells in matched tumor and blood from patients with ccRCC. We identified multiple distinct immune cell phenotypes for B and T (CD4 and CD8) lymphocytes, natural kill (NK) cells, and myeloid cells. Evaluation of T cell receptor (TCR) sequences revealed limited shared clonotypes between patients, whereas tumor-infiltrating T cell clonotypes were frequently found in peripheral blood, albeit in lower abundance. We further show that the circulating CD4 + T cell clonality is far less diverse than peripheral CD8 + . Evaluation of myeloid subsets revealed unique gene programs defining monocytes, dendritic cells and tumor-associated macrophages. In summary, here we have leveraged scRNA-seq to refine our understanding of the relative abundance, diversity and complexity of the immune landscape of ccRCC. This report represents the first characterization of ccRCC immune landscape using scRNA-seq. With further characterization and functional validation, these findings may identify novel sub-populations of immune cells amenable to therapeutic intervention. [Main Text:]

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“…From 1992 to 2008, RCC incidence increased by 2.4% per year, although the recorded incidence plateaued between 2008 and 2015. 3 A likely reason for these increased rates is due to more frequent utilization of abdominal imaging for other indications and resultant diagnosis of asymptomatic renal masses. 4 Subsequently, the incidence of smaller, local RCC has disproportionately increased.…”

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confidence: 99%

Systematic Review of Contemporary Evidence for the Management of T1 Renal Cell Carcinoma: What IRs Need to Know for Kidney Cancer Tumor Boards

Cronan

Dariushnia

Bercu

et al. 2019

Semin intervent Radiol

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Renal cell carcinoma is a relatively common malignancy, with 60 to 70 thousand cases a year in the United States alone. Increased utilization of cross-sectional imaging has led to an increase in the number of early renal cell cancers seen by the medical establishment. In addition, certain patient populations have an increased risk of developing kidney cancers which may mandate aggressive screening protocols. This article discusses the epidemiology of renal cell cancers; discusses the current management guidelines from multiple specialty societies; discusses some of the surgical and interventional techniques used in the treatment of such lesions; and provides a review of the literature regarding treatments of early-stage renal cell cancers.

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Trends in Renal-Cell Carcinoma Incidence and Mortality in the United States in the Last 2 Decades: A SEER-Based Study

Cited by 156 publications

References 45 publications

Comparative Survival Associated With Use of Targeted vs Nontargeted Therapy in Medicare Patients With Metastatic Renal Cell Carcinoma

Comparative Survival Associated With Use of Targeted vs Nontargeted Therapy in Medicare Patients With Metastatic Renal Cell Carcinoma

Mapping the Immune Landscape of Clear Cell Renal Cell Carcinoma by Single-Cell RNA-seq

Systematic Review of Contemporary Evidence for the Management of T1 Renal Cell Carcinoma: What IRs Need to Know for Kidney Cancer Tumor Boards

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