Management of advanced kidney cancer: Kidney Cancer Research Network of Canada (KCRNC) consensus update 2021

Abstract

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Diagnostic Accuracy of MRI for Solid Renal Masses: A Systematic Review and Meta‐analysis

“…The decision to perform a cytoreductive nephrectomy and the selection of systemic medical treatments are influenced by histologic subtypes where clear cell tumors are much more likely to respond to immunotherapy and tyrosine kinase inhibitors. 58 An accurate and noninvasive assessment of clear cell histology could potentially avoid the need for biopsy and facilitate earlier initiation of systemic treatments. 18 Canavsser et al, 43 and Schieda et al 47 used ccLS scores to diagnose ccRCC.…”

Advances in the management of renal cell carcinoma

“… 37 For patients with multiple comorbidities, and particularly with contraindications to immunotherapy, first-line single-agent VEGF-TKI (sunitinib or pazopanib) can be considered. 38 Active surveillance is an option for some patients with a low burden of metastatic disease who are asymptomatic. 38 After progression on or intolerance to first-line immune checkpoint inhibitor–based regimens, guidance from randomized trials for subsequent therapy is lacking, and the choice is made based on patient comorbidities, previous systemic therapy, and drug access through provincial funding or patient support programs.…”

Percées dans la prise en charge de l’hypernéphrome

“…Chez les personnes atteintes d’une maladie métastatique volumineuse causant un inconfort, l’association d’un inhibiteur du point de contrôle immunitaire et d’un ITK ciblant le VEGF pourrait être préférable en raison d’un taux de réponse objectif supérieur 37 . Pour les personnes présentant de multiples comorbidités, particulièrement s’il y a des contre-indications à l’immunothérapie, un agent unique ITK ciblant le VEGF (sunitinib ou paxopanib) peut être envisagé en traitement de première intention 38 . La surveillance active et aussi une option envisageable en présence d’un fardeau métastatique faible et d’une maladie asymptomatique 38 .…”