ASCO GU 2018: Title Dose Escalation of Cabozantinib as a Viable Option for the Treatment of mRCC

San Francisco, CA (UroToday.com) 
Background:
Cabozantinib (C) is a tyrosin kinase inhibitor (TKI) specific for VEGFR, MET and AXL. The phase-3 registration trial METEOR showed that C significantly improved progression-free and overall survival compared to Everolimus in patients with advanced/metastatic renal cell carcinoma (RCC) after failure of at least one VEGFR TKI.1 In METEOR, starting dose for C was 60 mg once daily and dose de-escalation to 40 or 20 mg or stopping of C was done based on toxicity. The median dose was 43 mg, and the dose had to be reduced in 62% of patients. The recommended starting dose of C is 60 mg. The authors hypothesized that starting with 40 mg of C and escalating to 60 mg after getting accustomed to side effects may lead to a higher median dose of C.

ASCO GU 2018: S-TRAC trial: Sensitivity Analyses of Disease-Free Survival

San Francisco, CA (UroToday.com) Disease free survival (DFS) has been frequently used as an endpoint in the adjuvant setting and was the primary basis of approval for adjuvant cancer therapies. In S-TRAC, adjuvant sunitinib demonstrated a significant improvement of DFS vs. placebo in patients with locoregional renal cell carcinoma (RCC) based on blinded independent central review.1 DFS was defined as time from randomization until recurrence or death from any cause or second cancer. In the absence of a standard definition of DFS in RCC, multiple sensitivity analyses were performed to confirm the robustness of the DFS results from S-TRAC.

ASCO GU 2018: High Dose Interleukin-2 and Response in 944 Patients with Metastatic Renal Cell Cancer (RCC): Data From the PROCLAIM Registry

San Francisco, CA (UroToday.com) Metastatic renal cell carcinoma (mRCC) is rarely a curable disease. While targeted therapies have radically changed the management of these disease and extended survival for many, they are not curative – all patients eventually progress.

ASCO GU 2018: Differential Expressions of PD-1, PD-L1, and PD-L2 Between the Primary and Metastatic Sites in Renal Cell Carcinoma

San Francisco, CA (UroToday.com) The immune checkpoint inhibitor nivolumab, an anti PD-1 monoclonal antibody, and the tyrosine kinase inhibitor (TKI) cabozantinib have both been shown in phase III clinical trials to be effective in metastatic renal cell carcinoma (mRCC) after progression on first-line therapy.1,2

ASCO GU 2018: Real World Outcomes of Nivolumab and Cabozantinib in Metastatic Renal Cell Carcinoma: Results from the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC)

San Francisco, CA (UroToday.com) The immune checkpoint inhibitor nivolumab, an anti PD-1 monoclonal antibody, and the tyrosine kinase inhibitor (TKI) cabozantinib have both been shown in phase III clinical trials to be effective in metastatic renal cell carcinoma (mRCC) after progression on first-line therapy.1,2 The authors, some of whom were involved in the original studies, went on to assess the real-world efficacy of these therapies in second-line mRCC.

ASCO GU 2018: Conditional Survival and Landmark Analysis for Patients with Small Renal Masses Undergoing Active Surveillance at a Tertiary Care Center

San Francisco, CA (UroToday.com) Conditional survival analyses have grown increasingly popular as they can provide guidance for patients once they have survived a period of time after diagnosis of their disease; it is a moving target, and this model helps address that.

ASCO GU 2018: Antibiotic Use and Outcomes with Systemic Therapy in Metastatic Renal Cell Carcinoma (mRCC)

San Francisco, CA (UroToday.com) This was an interesting study completed by a multi-institutional group in the setting of metastatic renal cell carcinoma (mRCC). RCC is known to be a malignancy with a high degree of local immune response and high mutational burden, hence the promising results of immune checkpoint inhibitors in the setting of metastatic disease and the efficacy of older immunotherapy (IL-2, etc).
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