Renal cell cancer 9 1 0 2 High incidence in North America and - - PowerPoint PPT Presentation

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Renal cell cancer 9 1 0 2 High incidence in North America and - - PowerPoint PPT Presentation

Oct 10, 2023 158 likes •616 views

Renal cell cancer 9 1 0 2 High incidence in North America and s Western Europe s a l Heterogeneous disease with c r different histological subtypes e t and disease biology s a M Local treatment by surgery, role for

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Renal cell cancer

New Cases 948 Deaths 448

  • High incidence in North America and

Western Europe

  • Heterogeneous disease with

different histological subtypes and disease biology

  • Local treatment by surgery,

role for surgery in oligometastatic disease

  • Treatment by TKI, VEGF and Checkpoint

Inhibition

data from http://www.globocan.iarc.fr 2012

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Incidence Mortality Renal Cell Cancer in Europe 2018

https://ecis.jrc.ec.europa.eu

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Cohen & McGovern NEM 2005;353:2477

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Metastastic Renal Cell Cancer

Sunitinib Pazopanib Temsirolimus IFN & Beva HD IL-2 Axitinib Nivolumab Cabozantinib Lenvatinib & Everolimus Everolimus Sorafenib Everolimus Sorafenib

Renal Cancer Drug Therapy 2018

Metastatic Metastatic Metastatic

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Local & locally advanced

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Male, 64 years presents with flank pain

Large right-sided mass, no distant metastases

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Metastatic Renal Cell Cancer

Sunitinib Pazopanib Temsirolimus IFN & Beva HD IL-2 Axitinib Nivolumab Cabozantinib Lenvatinib & Everolimus Everolimus Sorafenib Everolimus Sorafenib

Renal Cancer Drug Therapy 2018

Metastatic Metastatic Metastatic

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Metastatic Renal Cell Cancer

Sunitinib Pazopanib Temsirolimus IFN & Beva HD IL-2 Axitinib Nivolumab Cabozantinib Lenvatinib & Everolimus Everolimus Sorafenib Everolimus Sorafenib

Renal Cancer Drug Therapy 2018

Metastatic Metastatic Metastatic

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Metastatic Renal Cell Cancer

Sunitinib Pazopanib Temsirolimus IFN & Beva HD IL-2 Axitinib Nivolumab Cabozantinib Lenvatinib & Everolimus Everolimus Sorafenib Everolimus Sorafenib

Renal Cancer Drug Therapy 2018

Metastatic Metastatic Metastatic

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Metastatic

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Prognosis ?

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International mRCC Database Consortium (IMDC) Criteria<br />

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IMDC Criteria in First-Line Targeted Therapy

Presented By Daniel Heng at 2018 ASCO Annual Meeting

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IMDC Criteria in Second-Line Targeted Therapy

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IMDC Criteria in Third-Line Targeted Therapy

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IMDC in Non-clear Cell RCC <br />Kroeger N et al Cancer 2013

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Management Primary ?

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CARMENA: Prospective, multicenter, open-label, randomized, phase 3 non-inferiority study

Presented By Arnaud Mejean at 2018 ASCO Annual Meeting

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Patient population

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Overall <br />survival (ITT)

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NEJM 2018; 379:417

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First-line treatment ?

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Metastatic Renal Cell Cancer

Sunitinib Pazopanib Temsirolimus IFN & Beva HD IL-2 Nivolumab Axitinib Cabozantinib Lenvatinib & Everolimus Everolimus Sorafenib Everolimus Sorafenib

Renal Cancer Drug Therapy 2018

Metastatic Metastatic Metastatic

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NEJM 2013;369:722

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Metastatic Renal Cell Cancer

Sunitinib Pazopanib Temsirolimus IFN & Beva HD IL-2 Nivolumab Axitinib Cabozantinib Lenvatinib & Everolimus Everolimus Sorafenib Everolimus Sorafenib

Renal Cancer Drug Therapy 2018

Metastatic Metastatic Metastatic

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Escudier et al ESMO 2017 LBA5

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24.980.- CHF per 6 weeks 5.476.- CHF per 6 weeks

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23.377.- CHF per 6 weeks 5.476.- CHF per 6 weeks

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21.307.- CHF per 6 weeks 5.476.- CHF per 6 weeks

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Metastatic Renal Cell Cancer

Sunitinib Pazopanib Nivo & Ipi Pem & Axitinib Ave & Axitinib Atezo & Bev

? Axitinib ? Nivolumab ? Cabozantinib ? Lenvatinib & Everolimus ? Everolimus ? Sorafenib

? Everolimus ? Sorafenib

Renal Cancer Drug Therapy 2019

Metastatic Metastatic Metastatic

???

12-15 months

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Metastatic Renal Cell Cancer

Sunitinib Pazopanib Nivo & Ipi Pem & Axitinib Ave & Axitinib Atezo & Bev

? Axitinib ? Nivolumab ? Cabozantinib ? Lenvatinib & Everolimus ? Everolimus ? Sorafenib

? Everolimus ? Sorafenib

Renal Cancer Drug Therapy 2019

Metastatic Metastatic Metastatic

???

12-15 months

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S M O E E B R M a s t e r c l a s s 2 1 9

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Metastatic Renal Cell Cancer

Sunitinib Pazopanib Nivo & Ipi Pem & Axitinib Ave & Axitinib Atezo & Bev

? Axitinib ? Nivolumab ? Cabozantinib ? Lenvatinib & Everolimus ? Everolimus ? Sorafenib

? Everolimus ? Sorafenib

Renal Cancer Drug Therapy 2019

Metastatic Metastatic Metastatic

???

12-15 months

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S M O E E B R M a s t e r c l a s s 2 1 9

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Metastatic Renal Cell Cancer

Sunitinib Pazopanib Nivo & Ipi Pem & Axitinib Ave & Axitinib Atezo & Bev

? Axitinib ? Nivolumab ? Cabozantinib ? Lenvatinib & Everolimus ? Everolimus ? Sorafenib

? Everolimus ? Sorafenib

Renal Cancer Drug Therapy 2019

Metastatic Metastatic Metastatic

???

12-15 months

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Plenary Session

2019

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Plenary Session

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Plenary Session

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