New Paradigms for Cytoreductive Nephrectomy

Lichtbroun, Benjamin; Srivastava, Arnav; Doppalapudi, Sai Krishnaraya; Chua, Kevin; Singer, Eric A.

doi:10.3390/cancers14112660

Cited by 9 publications

(8 citation statements)

References 33 publications

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“…Five trials examining the modern role of cytoreductive nephrectomy are currently underway: the NORDIC-SUN (ID: NCT03977571), PROBE (ID: NCT04510597), and Cyto-KIK (ID: NCT04322955) trials, as well as two others (IDs: NCT02210117 and NCT04370509; Table 4). Results from these trials are expected between 2023 and 2033 [69][70][71][72].…”

Section: Cytoreductive Nephrectomymentioning

confidence: 99%

Two is company, is three a crowd? Triplet therapy, novel molecular targets, and updates on the management of advanced renal cell carcinoma

Goodstein¹,

Yang

Runcie

et al. 2023

Current Opinion in Oncology

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Purpose of reviewThe purpose of this review is to highlight the most recent changes in the management of advanced renal cell carcinoma, a complicated and ever-changing field of research. Recent findingsA recent meta-analysis examining combination therapy favors nivolumab plus cabozantinib as the overall survival leader in doublet therapy. Initial results on the first ever trial of triplet therapy have demonstrated improved progression-free survival over current standard of care. The hypoxia-inducible factor-2a (HIF-2a) inhibitor belzutifan is FDA approved for patients with von Hippel-Lindau disease and is currently being investigated in patients with nonhereditary renal cell carcinoma. The new glutamate synthesis inhibitor, telaglenastat, perhaps confers synergistic benefit when combined with everolimus, but combination with cabozantinib was not so effective. Dual mammalian target of rapamycin (mTOR) inhibition with sapanisertib does not appear to be an effective therapeutic option. New biomarkers and targets are actively being investigated. Four recent trials examining alternative agents to pembrolizumab in the adjuvant setting did not demonstrate an improvement in recurrence-free survival. Cytoreductive nephrectomy in the combination therapy era is supported by retrospective data; clinical trials are recruiting patients.

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Section: Cytoreductive Nephrectomymentioning

confidence: 99%

Two is company, is three a crowd? Triplet therapy, novel molecular targets, and updates on the management of advanced renal cell carcinoma

Goodstein¹,

Yang

Runcie

et al. 2023

Current Opinion in Oncology

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“…4 CN should be considered for patients with one International mRCC Database Consortium (IMDC) risk factor (intermediate-risk disease). 5 Although a definitive prognostication system for CN is lacking, 6 optimal candidates for CN have the significant majority of their tumor burden within the kidney, have good Eastern Cooperative Oncology Group performance status, and do not have brain, bone, or liver metastases. 7 IMDC poor-risk patients are likely to benefit more from immediate systemic therapy, although delayed CN can be considered with good response to systemic treatment.…”

Section: Question: What Is the Role Of Cytoreductive Nephrectomy In M...mentioning

confidence: 99%

Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline Q&A

Singer

Rumble

Veldhuizen

2023

JCO Oncology Practice

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“…Overall, 70% (n=550) of the patients were randomly divided into the training cohorts, while the remaining 30% (n=232) were assigned to the internal test cohort. The median follow-up was 25 (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) months in the SEER database. A total of 144 patients were included in the external test (PUMCH) cohort, and the median follow-up for this cohort was 37 (24-52) months.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

Machine learning to improve prognosis prediction of metastatic clear-cell renal cell carcinoma treated with cytoreductive nephrectomy and systemic therapy

Yang

Dong

et al. 2022

Bosn J of Basic Med Sci

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Cytoreductive nephrectomy (CN) combined with systemic therapy is commonly used to treat metastatic clear-cell renal cell carcinoma (mccRCC). However, prognostic models for these patients are limited. In the present study, the clinical data of 782 mccRCC patients who received both CN and systemic therapy were obtained from the Surveillance, Epidemiology, and End Results (SEER) database (2010-2016), and patients were divided into training and internal test cohorts. A total of 144 patients who met the same criteria from our center (Peking Union Medical College Hospital) were placed in the external test cohort. The cancer-specific survival rate (CSS) at 1, 3, and 5 years was set as the research outcome. Then, four ML models, i.e., a gradient boosting machine (GBM), support vector machine (SVM), random forest (RF), and logistic regression (LR), were established. Fifteen potential independent features were included in this study. Model performance was evaluated using the area under the receiver operating characteristic curves (AUC), calibration plots, and decision curve analysis (DCA). Seven clinical features, namely pathological grade, T stage, N stage, number of metastatic sites, brain or liver metastases, and metastasectomy were selected for subsequent analysis via the recursive feature elimination (RFE) algorithm. In conclusion, the GBM model performed best at 1-, 3- and 5-year CSS prediction (0.836, 0.819 and 0.808, respectively in the internal test cohort and 0.819, 0.805 and 0.786, respectively in the external cohort). Furthermore, we divided the patients into three strata (high-, intermediate- and low-risk) via X-tile analysis and concluded that clinically individualized treatment can be aided by these practical prognostic models.

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New Paradigms for Cytoreductive Nephrectomy

Cited by 9 publications

References 33 publications

Two is company, is three a crowd? Triplet therapy, novel molecular targets, and updates on the management of advanced renal cell carcinoma

Two is company, is three a crowd? Triplet therapy, novel molecular targets, and updates on the management of advanced renal cell carcinoma

Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline Q&A

Machine learning to improve prognosis prediction of metastatic clear-cell renal cell carcinoma treated with cytoreductive nephrectomy and systemic therapy

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