TKI in Poor-Risk Advanced Renal Cell Carcinoma
TKI in Poor-Risk Advanced Renal Cell Carcinoma
Case: A 68-Year-Old Man With Poor-Risk RCC
A 68-year-old man presented with a 6-week history of painless intermittent hematuria, fatigue and a 7-lb weight loss.
H & P:
- History of medically controlled hypertension and hypercholesterolemia
- 30 pack/year smoking history, social alcohol use
- Thin, ill-appearing; able to meet activities of daily living but unable to work due to fatigue. He spends more than half the day active on his feet
Labs:
- CBC: Hb 11.4 g/dL, corrected Calcium,11.2 mg/dL, WBC, PLT, LFT all WNL
- BP: 134/92
- Lipid panel: WNL
- U/A: gross hematuria
Imaging:
- CT scan of the chest/abdomen/pelvis showed a left-sided 8.7 (I believe he said 8cm) cm renal mass, para-aortic lymph nodes, and pulmonary metastases
Diagnosis:
- Underwent radical left nephrectomy; found to have Fuhrman grade 4 clear cell carcinoma without sarcomatoid features
- IMDC risk-score: poor
Treatment:
- Initiated treatment with ipilimumab 1mg/kg IV + nivolumab 3mg/kg IV q3w for 4 doses; achieved partial response; received maintenance nivolumab for 6 doses (q4w) followed by disease progression
- Patient was switched to cabozantinib 60mg PO qDay
Long-Term Ipi/Nivo RCC Data Show Durability Across Risk Groups
April 12th 2024During a Case-Based Roundtable® event, Ulka Vaishampayan, MBBS, discussed the 8-year follow-up data of ipilimumab plus nivolumab in patients with advanced renal cell carcinoma In the first article of a 2-part series.
Read More
Enhancing Precision in Immunotherapy: CD8 PET-Avidity in RCC
March 1st 2024In this episode of Emerging Experts, Peter Zang, MD, highlights research on baseline CD8 lymph node avidity with 89-Zr-crefmirlimab for the treatment of patients with metastatic renal cell carcinoma and response to immunotherapy.
Listen
Beyond the First-Line: Economides on Advancing Therapies in RCC
February 1st 2024In our 4th episode of Emerging Experts, Minas P. Economides, MD, unveils the challenges and opportunities for renal cell carcinoma treatment, focusing on the lack of therapies available in the second-line setting.
Listen
George Discusses Potency of VEGF TKIs in Advanced Renal Cell Carcinoma
March 22nd 2024During a Case-Based Roundtable® event, Saby George, MD, discussed the case of a patient with clear cell renal cell carcinoma who progressed after left nephrectomy followed by treatment with axitinib plus pembrolizumab at recurrence.
Read More
Unique Challenges of Using IO/TKI Combinations in Metastatic RCC
March 12th 2024During a Targeted Oncology™ Case-Based Roundtable™ event, Robert J. Motzer, MD, asked participants to share their experiences using nivolumab plus cabozantinib in patients with advanced renal cell carcinoma. This is the second of 2 articles based on this event.
Read More
