Robert J. Motzer, MD:The risk stratification models were originally developed at MSKCC to help prognosticate patients for counseling, in terms of patients’ individual prognosis, but also to be used in clinical trials both for eligibility and in comparing results. The 2 groupings that are widely used are the MSKCC system, and a modification of the MSKCC system, the international consensus criteria. They’re both very similar. They use 5 and 6 different pretreatment clinical features to help stratify patients into favorable, intermediate, and poor-risk features, both at initial diagnosis or at time of treatment with second- or third-line therapy.
Originally when this patient presented with metastatic disease, he fell into the intermediate-risk group based on the fact that he was anemic, and the median survival for patients with intermediate-risk RCC is approximately 20 to 25 months in a modern-day therapy. At time of progression on sunitinib he also fell into the intermediate-risk group. The intermediate-risk group is the group that most patients with metastatic kidney cancer fall into. In both systems between 40% and 50% of patients are intermediate-risk at initial diagnosis, and more than that at relapse for second- or third-line therapy.
Transcript edited for clarity.
A Japanese-American Male With Recurrent RCC