GRACE :: Kidney Cancer

Management of Rare Kidney Tumors

What puts you at risk for inherited kidney cancer? Dr. Nizar Tannir discusses the signs doctors look for to determine if a kidney cancer patient should be screened for a familial syndrome.


NanoString Treatment for Kidney Cancer

NanoString Technology may help doctors learn what is driving tumor growth in kidney cancer patients and, therefore, determine what treatments may be most effective for them.


How is the Heng Criteria Applied to Kidney Cancer Patients?

Dr. Daniel Heng is the namesake of the Heng Criteria, which evaluates various factors of kidney cancer patients to determine their prognoses.


What is PD1 and PDL1 in Kidney Cancer?

Dr. Lauren Harshman explains what PD1 (an immune T-cell) and PDL1 (a protein on the PD1 T-cell) are and how new drugs impact them to fight kidney cancer.


No Clear Answer for Non-Clear Cell Kidney Cancer

Drugs in early stage clinical trials seem to show benefit for non-clear cell kidney cancer, but more trials must take place and patients are desperately needed to enroll in them.


Treating Newly Diagnosed Kidney Cancer

Dr. Guru Sonpavde discusses what he does when he first begins treating a patient recently diagnosed with late stage kidney cancer.


The Hottest Thing in Late Stage Kidney Cancer

Patients are responding very well to the next generation of immunotherapy drugs currently in clinical trials to treat kidney cancer.


Facilitating Partial Nephrectomy with Pre-Operative Pazopanib

When a patient has a localized renal mass, a partial nephrectomy is the desired surgical approach because it preserves renal function. Depending on the tumor size and location, a partial nephrectomy is not always possible. In these cases, pazopanib, a VEGF-targeted agent that has had an anti-tumor effect in primary renal cell carcinoma (RCC) tumors, may prevent patients from undergoing a radical nephrectomy and open up  the option of a partial nephrectomy. Dr. Alvarez and colleagues presented data at the 2014 ASCO annual meeting. In their study, 23 patients with clear cell RCC were identified who were not well suited for radical nephrectomy (due to poor kidney function, high risk of morbidity or complex vascular anatomy). Pazopanib was then administered for median of 10.6 weeks.  Tumor shrinkage was noted in 95% of patients, and ultimately 90% of patients were able to undergo partial nephrectomy.  Although this approach requires further validation, this might be an interest manner in which we can ultimately downsize kidney tumors and facilitate a less invasive surgical intervention.  

This post was co-written by Dr. Pal and Melissa Houlemarde


Combining Drugs to Improve Efficacy?

Patients with metastatic renal cell carcinoma (mRCC) are commonly treated by inhibiting VEGF and mTOR pathways.  Over the years, there has been substantial interest in seeing how inhibitors of these pathways can be combined.  In a phase II study presented by Dr, Kathleen Mahoney and colleagues at ASCO 2014, the combination of bevacizumab (a VEGF-inhibitor) and temsirolimus (an mTOR inhibitor) was explored.  Patients had both clear cell and non clear cell disease, and had failed prior VEGF inhibitors. Forty patients received this treatment until their disease progressed or they reached unacceptable toxicity. Ultimately, 77.5% of patients had a dose reduction, while 27.5% were taken off the study due to toxicity (e.g., fatigue, dyslipidemia, and proteinuria). These results are somewhat consistent with those from the TORAVA study, a large experience comparing this regimen to bevacizumab/interferon-alfa and sunitinib.  In that previous study, many patients were unable to tolerate full doses of each drug.  The combination resulted in a delay in cancer growth of 5.8 months in the overall study population. Impressively, in patients with non-clear cell disease, the delay in cancer growth was 7.6 months.  Thus, we might need to look further at this regimen for folks with non-clear cell disease. 

This post was co-written by Dr. Pal and Melissa Houlemarde


What Is Non-Clear Cell Kidney Cancer?

Among kidney cancer patients, the sub-type “non-clear cell” is the least common. As a result, not much research has been conducted on it.


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