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Renal Cell Cancer Case Studies

Case Studies: Intermediate-Risk Newly Diagnosed Metastatic Renal Cell Carcinoma

In this case-based interview, Daniel George, MD, reviews the case of a patient diagnosed with metastatic renal cell carcinoma and explains his recommendations for treating this patient with vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor (TKI) therapy.

Intermediate-Risk Newly Diagnosed Metastatic Renal Cell Carcinoma

Case Scenario: A 52-year old male with mRCC

February 2018

  • A 52-year old Caucasian man presented to his physician complaining of severe left-sided back pain
  • Laboratory findings: mild anemia, otherwise WNL
  • CT scan of the abdomen and pelvis showed a large left renal mass, several small lytic lesions in the lumbar and thoracic vertebrae, and a small pulmonary nodule
  • The patient underwent cytoreductive nephrectomy
  • Diagnosis; stage IV clear-cell renal cell carcinoma; good-risk
  • He received radiation therapy to his spinal lesions and was then started on cabozantinib 60 mg daily
  • The patient reported moderate nausea and vomiting and diarrhea after 6 weeks on therapy; he continues to do well with improved tolerance after dose adjustment to 40 mg
  • Imaging at 3 months showed a significant decrease in size of the pulmonary nodule
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