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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Phase II Trial Compares PET Imaging to Conventional Scans Post-Nephrectomy
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Brian Shuch, MD
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| Pedro Barata is joined by Brian Shuch to discuss his investigator-initiated phase 2 trial evaluating girentuximab PET-CT imaging for detecting residual disease after nephrectomy in clear cell renal cell carcinoma.
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Real-World Experience With the Expanded Access Program for 89Zr-Girentuximab PET in Small Renal Masses
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R. Jonathan Henderson, MD
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| Zachary Klaassen hosts Jonathan Henderson to discuss his experience with the Expanded Access Program for [89Zr]Zr-girentuximab PET imaging for small renal masses. Dr. Henderson shares insights from implementing this technology in his high-volume Arkansas practice, noting that the ZIRCON trial demonstrated approximately 90% sensitivity and specificity for identifying clear cell renal cell carcinoma.
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Advancing Imaging Techniques for Indeterminate Renal Mass Diagnosis and Clinical Decision-Making
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Sam Chang, MD, MBA
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| Zach Klaassen and Sam Chang discuss the ZIRCON trial, which highlights a novel PET-CT imaging modality targeting carbonic anhydrase IX (CAIX) for diagnosing small renal masses, particularly clear cell renal cell carcinoma (ccRCC).
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| Functional Imaging in Renal Cell Carcinoma: Enhancing Diagnosis and Treatment Strategies
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| Michael Hofman, MBBS, FRACP, FAANMS, FICIS, GAICD
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| Michael Hofman highlighted advances in functional imaging for renal cell carcinoma (RCC), emphasizing Carbonic Anhydrase IX (CA-IX) as a key theranostic target analogous to PSMA in prostate cancer. He presented results from recent trials showing that CA-IX–targeted PET/CT imaging agents, such as the antibody-based ⁸⁹Zr-DFO-girentuximab and the peptide-based ⁶⁸Ga-DPI-4452, enable earlier, more accurate, and lower-radiation detection of clear cell RCC. Ongoing research suggests promising therapeutic potential for CA-IX–directed radioligand treatments, though no CA-IX theranostic agents are yet approved.
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| Perioperative Systemic Therapy in High-Risk Renal Cell Carcinoma Following Nephrectomy: A Narrative Review - Beyond the Abstract
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| Adam Khorasanchi, MD and Yuanquan Yang, MD, PhD
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| This narrative review outlines current and emerging approaches to perioperative systemic therapy for high-risk localized clear-cell RCC after nephrectomy, emphasizing that recurrence risk remains substantial despite curative surgery. Adjuvant pembrolizumab, supported by KEYNOTE-564, is the only approved therapy in this setting, while other ICI and TKI trials have been negative; ongoing perioperative trials and biomarker efforts aim to better select patients and reduce overtreatment.
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| Cost-Effectiveness Analysis of 89Zr-Girentuximab PET—CT (TLX250) to Guide Management of Small Renal Masses
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| Pratik Kanabur, MD
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| Pratik Kanabur presented a Markov model–based cost-effectiveness analysis comparing empiric partial nephrectomy, renal mass biopsy, TLX250 PET/CT alone, and TLX250 PET/CT with reflex biopsy for negative scans to guide management of small renal masses in a 65-year-old patient. In base case analysis, TLX250 followed by biopsy for negative scans minimized the risk of untreated malignant tumors and maximized avoidance of treatment for benign lesions, emerging as the most cost-effective strategy, while broader modeling and probabilistic analysis showed TLX250 alone to be the most cost-effective approach across a range of costs and parameter uncertainties.
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| Five-Year Follow-Up Results from the Phase 3 KEYNOTE-564 Study of Adjuvant Pembrolizumab for the Treatment of Clear Cell Renal Cell Carcinoma
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| Naomi Haas, MD
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| Five-year follow-up from KEYNOTE-564 confirms that adjuvant pembrolizumab after nephrectomy provides durable improvements in disease-free and overall survival for patients with clear cell RCC at increased risk of recurrence, with 5-year DFS of about 61% versus 52% and OS of about 88% versus 82% versus placebo.
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Urine Glycosaminoglycan Scores for Surveillance of Recurrence in Intermediate- and High-risk Nonmetastatic Clear Cell Renal Cell Carcinoma-An Observational Prospective Multicentre Diagnostic Test Cohort Study - Beyond the Abstract
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| Saeed Dabestani, Nessn H Azawi, Riccardo Campi et al.
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| Dabestani et al. describes the AURORAX-0087A prospective multicentre study evaluating a urine-based glycosaminoglycan “GAGome” score as a noninvasive biomarker for surveillance after nephrectomy in intermediate- and high-risk nonmetastatic ccRCC. In Cohort 1, elevated GAGome scores showed high sensitivity and negative predictive value for recurrence detection with a median 4.2‑month lead time over CT imaging, and each 10‑point score increase was associated with a substantially higher recurrence risk, suggesting potential to refine follow-up intensity and possibly inform adjuvant treatment decisions if validated in the ongoing Cohort 2.
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