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  1. Article: How I Do It: Maintenance avelumab for advanced urothelial carcinoma

    Lalani, Aly-Khan A

    The Canadian journal of urology

    2023  Volume 30, Issue 4, Page(s) 11633–11638

    Abstract: For more than four decades, platinum-based chemotherapy regimens have served as the established standard-of-care for advanced urothelial carcinoma (aUC). However, advancements in our understanding of cancer biology and tumor microenvironment have ... ...

    Abstract For more than four decades, platinum-based chemotherapy regimens have served as the established standard-of-care for advanced urothelial carcinoma (aUC). However, advancements in our understanding of cancer biology and tumor microenvironment have reshaped the therapeutic landscape and prognosis of this incurable disease. Immune checkpoint inhibitors (ICIs) that target programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) are firmly established tools in aUC management, leading to enhanced life span and improved quality of life for patients. In patients who achieved stable disease or better following platinum-based chemotherapy, maintenance therapy with the PD-L1 antibody avelumab significantly enhanced overall survival (OS) by approximately 7 months compared to best supportive care in the phase 3 JAVELIN Bladder 100 trial. As a result, avelumab received FDA approval in June 2020 as a maintenance therapy for aUC patients treated with first-line platinum-based chemotherapy. Therefore, aUC care plans should incorporate maintenance avelumab into standard first-line treatment regimens for these patients. The objective of this brief article is to provide insight into the utilization of avelumab, identify patients who may benefit from this treatment, and review the methodology, advantages, potential side effects and their management.
    MeSH term(s) Humans ; B7-H1 Antigen ; Carcinoma, Transitional Cell/drug therapy ; Quality of Life ; Urinary Bladder Neoplasms/drug therapy ; Tumor Microenvironment
    Chemical Substances avelumab (KXG2PJ551I) ; B7-H1 Antigen
    Language English
    Publishing date 2023-08-24
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2064475-9
    ISSN 1195-9479
    ISSN 1195-9479
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The emerging landscape of neo/adjuvant immunotherapy in renal cell carcinoma.

    Dibajnia, Pooya / Cardenas, Luisa M / Lalani, Aly-Khan A

    Human vaccines & immunotherapeutics

    2023  Volume 19, Issue 1, Page(s) 2178217

    Abstract: Adjuvant and neoadjuvant therapies that reduce the risk of renal cell carcinoma (RCC) recurrence remain an area of unmet need. Advances have been made in metastatic RCC recently by leveraging PD-1/PD-L1 immune checkpoint inhibitors (ICIs). These agents ... ...

    Abstract Adjuvant and neoadjuvant therapies that reduce the risk of renal cell carcinoma (RCC) recurrence remain an area of unmet need. Advances have been made in metastatic RCC recently by leveraging PD-1/PD-L1 immune checkpoint inhibitors (ICIs). These agents are currently being investigated in the adjuvant and neoadjuvant settings to determine if intervention early in the disease trajectory offers a clinically meaningful benefit. While a disease-free survival benefit has been demonstrated with pembrolizumab, results from other ICI studies have not been positive to date. More mature data from these studies are needed to determine whether there is a survival benefit to ICIs in the curative-intent setting. The success of ICIs has also ushered a new wave of studies combining ICIs with other agents such as targeted therapies and vaccines, which are in early stages of investigation. We review the current state of adjuvant/neoadjuvant therapy in RCC and highlight opportunities for ongoing study.
    MeSH term(s) Humans ; Carcinoma, Renal Cell/therapy ; Kidney Neoplasms/therapy ; Neoplasm Recurrence, Local ; Adjuvants, Immunologic ; Immunotherapy/methods
    Chemical Substances Adjuvants, Immunologic
    Language English
    Publishing date 2023-02-12
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 2664176-8
    ISSN 2164-554X ; 2164-5515
    ISSN (online) 2164-554X
    ISSN 2164-5515
    DOI 10.1080/21645515.2023.2178217
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Advances in the management of renal cell carcinoma.

    Cardenas, Luisa M / Sigurdson, Samantha / Wallis, Christopher J D / Lalani, Aly-Khan / Swaminath, Anand

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2024  Volume 196, Issue 7, Page(s) E235–E240

    MeSH term(s) Humans ; Carcinoma, Renal Cell/surgery ; Kidney Neoplasms/surgery ; Nephrectomy
    Language English
    Publishing date 2024-02-25
    Publishing country Canada
    Document type Journal Article ; Review
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.230356
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: From Famine to Feast: Treating Urinary Malignancies in the Immunotherapy Era.

    Lalani, Aly-Khan A

    European urology focus

    2019  Volume 6, Issue 1, Page(s) 1–2

    MeSH term(s) Bone Diseases ; Humans ; Immunotherapy ; Neoplasms
    Language English
    Publishing date 2019-12-05
    Publishing country Netherlands
    Document type Editorial ; Comment
    ISSN 2405-4569
    ISSN (online) 2405-4569
    DOI 10.1016/j.euf.2019.11.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Optimizing Treatment Selection in Advanced Renal Cell Carcinoma via IMDC Risk Group Stratification.

    Hird, Amanda E / Chavarriaga, Julián / Lalani, Aly-Khan A / Wallis, Christopher J D

    European urology

    2023  Volume 84, Issue 4, Page(s) 379–380

    MeSH term(s) Humans ; Carcinoma, Renal Cell/pathology ; Kidney Neoplasms/pathology ; Risk Factors ; Retrospective Studies
    Language English
    Publishing date 2023-07-14
    Publishing country Switzerland
    Document type Editorial ; Comment
    ZDB-ID 193790-x
    ISSN 1873-7560 ; 1421-993X ; 0302-2838
    ISSN (online) 1873-7560 ; 1421-993X
    ISSN 0302-2838
    DOI 10.1016/j.eururo.2023.06.025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Cytoreductive stereotactic body radiotherapy (SBRT) and combination SBRT with immune checkpoint inhibitors in metastatic renal cell carcinoma.

    Peng, Jonathan / Lalani, Aly-Khan / Swaminath, Anand

    Canadian Urological Association journal = Journal de l'Association des urologues du Canada

    2021  Volume 15, Issue 8, Page(s) 281–286

    Abstract: Introduction: Preclinical evidence demonstrates the immunogenic potential of stereotactic body radiotherapy (SBRT). There is growing interest in investigating this interplay with the immune system in metastatic renal cell carcinoma (mRCC). Cytoreduction ...

    Abstract Introduction: Preclinical evidence demonstrates the immunogenic potential of stereotactic body radiotherapy (SBRT). There is growing interest in investigating this interplay with the immune system in metastatic renal cell carcinoma (mRCC). Cytoreduction with SBRT and combination therapy with SBRT and checkpoint inhibitor immuno-oncology agents (IO) are two potential therapeutic strategies in mRCC. In this review, we summarize the current clinical evidence for the use of cytoreductive SBRT to primary kidney and combination SBRT with IO.
    Methods: A literature review for articles and abstracts published between January 2000 and March 2020 was conducted through the PubMed, the American Society of Clinical Oncology (ASCO), and the American Society of Radiation Oncology (ASTRO) databases. Evaluation of studies followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) criteria.
    Results: A total of three articles for cytoreductive SBRT and one article and three abstracts for combination SBRT and IO in mRCC met inclusion criteria for this review. Evidence for SBRT to primary kidney is limited by small series and pilot studies. Outcomes vary widely due to small patient numbers and study heterogeneity. Local control ranges from 85-100% and one- and two-year overall survival ranges from 38-71% and 19-53%, respectively. Combination SBRT and IO are tolerable for patients with early data, suggesting grade 3-4 adverse event rates of 0-24%. Long-term survival data is not yet available.
    Conclusions: Cytoreductive SBRT and combination SBRT with IO therapy represent promising treatment strategies in mRCC. The evidence for clinical benefit is currently limited and requires further study with well-designed, randomized controlled trials.
    Language English
    Publishing date 2021-01-07
    Publishing country Canada
    Document type Journal Article ; Review
    ZDB-ID 2431403-1
    ISSN 1911-6470
    ISSN 1911-6470
    DOI 10.5489/cuaj.6963
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Emerging Biomarkers of Response to Systemic Therapies in Metastatic Clear Cell Renal Cell Carcinoma.

    Labaki, Chris / Saliby, Renee Maria / Bakouny, Ziad / Saad, Eddy / Semaan, Karl / Eid, Marc / Lalani, Aly-Khan / Choueiri, Toni K / Braun, David A

    Hematology/oncology clinics of North America

    2023  Volume 37, Issue 5, Page(s) 937–942

    Abstract: Patients with metastatic clear cell renal cell carcinoma (mccRCC) experience highly heterogeneous outcomes when treated with standard-of-care systemic regimens. Therefore, valid biomarkers are needed to predict the clinical response to these therapies ... ...

    Abstract Patients with metastatic clear cell renal cell carcinoma (mccRCC) experience highly heterogeneous outcomes when treated with standard-of-care systemic regimens. Therefore, valid biomarkers are needed to predict the clinical response to these therapies and help guide management. In this review, the authors outline relevant and promising biomarkers for patients with mccRCC receiving systemic therapies, with a focus on immunotherapy-based regimens.
    MeSH term(s) Humans ; Carcinoma, Renal Cell/drug therapy ; Carcinoma, Renal Cell/pathology ; Kidney Neoplasms/drug therapy ; Kidney Neoplasms/pathology ; Immunotherapy ; Biomarkers
    Chemical Substances Biomarkers
    Language English
    Publishing date 2023-07-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 93115-9
    ISSN 1558-1977 ; 0889-8588
    ISSN (online) 1558-1977
    ISSN 0889-8588
    DOI 10.1016/j.hoc.2023.05.021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Capturing recurrence in urothelial carcinoma: "more than meets the eye".

    Lalani, Aly-Khan A / Pal, Sumanta K / Sonpavde, Guru P / Grivas, Petros

    Translational andrology and urology

    2020  Volume 8, Issue Suppl 5, Page(s) S524–S527

    Language English
    Publishing date 2020-01-23
    Publishing country China
    Document type Editorial ; Comment
    ZDB-ID 2851630-8
    ISSN 2223-4691 ; 2223-4691 ; 2223-4683
    ISSN (online) 2223-4691
    ISSN 2223-4691 ; 2223-4683
    DOI 10.21037/tau.2019.12.06
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Next Wave of Targets in the Treatment of Advanced Renal Cell Carcinoma.

    Cardenas, Luisa M / Deluce, Jasna E / Khan, Shahrukh / Gulam, Omar / Maleki Vareki, Saman / Fernandes, Ricardo / Lalani, Aly-Khan A

    Current oncology (Toronto, Ont.)

    2022  Volume 29, Issue 8, Page(s) 5426–5441

    Abstract: While surgical resection has remained the mainstay of treatment in early-stage renal cell carcinoma (RCC), therapeutic options in the advanced setting have remarkably expanded over the last 20 years. Tyrosine kinase inhibitors targeting the vascular ... ...

    Abstract While surgical resection has remained the mainstay of treatment in early-stage renal cell carcinoma (RCC), therapeutic options in the advanced setting have remarkably expanded over the last 20 years. Tyrosine kinase inhibitors targeting the vascular endothelial growth factor receptor (VEGF-TKIs) and anti-programmed cell death 1 (PD-1)/anti-programmed death-ligand 1 (PD-L1)-based immune checkpoint inhibitors (ICIs) have become globally accepted options in the upfront metastatic setting, with different ICI-based combination strategies improving overall survival compared to single-agent Sunitinib. Although some patients benefit from long-term responses, most eventually develop disease progression. Ongoing efforts to better understand the biology of RCC and the different mechanisms of acquired resistance have led to the identification of promising therapeutic targets. Belzutifan, a novel agent targeting the angiogenic pathway involving hypoxia-inducible factors (HIFs), has already been approved for the treatment of early-stage tumors associated with VHL disease and represents a very promising therapy in advanced RCC. Other putative targets include epigenetic regulation enzymes, as well as several metabolites such as adenosine, glutaminase and tryptophan, which are critical players in cancer cell metabolism and in the tumor microenvironment. Different methods of immune regulation are also being investigated, including CAR-T cell therapy and modulation of the gut microbiome, in addition to novel agents targeting the interleukin-2 (IL-2) pathway. This review aims to highlight the emergent novel therapies for RCC and their respective completed and ongoing clinical trials.
    MeSH term(s) Antineoplastic Agents/therapeutic use ; Carcinoma, Renal Cell/drug therapy ; Carcinoma, Renal Cell/pathology ; Epigenesis, Genetic ; Humans ; Kidney Neoplasms/drug therapy ; Tumor Microenvironment ; Vascular Endothelial Growth Factor A/metabolism ; Vascular Endothelial Growth Factor A/pharmacology
    Chemical Substances Antineoplastic Agents ; Vascular Endothelial Growth Factor A
    Language English
    Publishing date 2022-07-30
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 1236972-x
    ISSN 1718-7729 ; 1198-0052
    ISSN (online) 1718-7729
    ISSN 1198-0052
    DOI 10.3390/curroncol29080429
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Evolving landscape of first-line combination therapy in advanced renal cancer: a systematic review.

    Lalani, Aly-Khan A / Heng, Daniel Y C / Basappa, Naveen S / Wood, Lori / Iqbal, Nayyer / McLeod, Deanna / Soulières, Denis / Kollmannsberger, Christian

    Therapeutic advances in medical oncology

    2022  Volume 14, Page(s) 17588359221108685

    Abstract: Background: Renal cell carcinoma (RCC) is a common malignancy with approximately 30% of cases diagnosed at the advanced or metastatic stage. While single-agent vascular endothelial growth factor-targeted therapy has been a mainstay of treatment, data ... ...

    Abstract Background: Renal cell carcinoma (RCC) is a common malignancy with approximately 30% of cases diagnosed at the advanced or metastatic stage. While single-agent vascular endothelial growth factor-targeted therapy has been a mainstay of treatment, data from multiple phase III trials assessing first-line immune checkpoint inhibitor (ICI) combinations have demonstrated a significant survival benefit.
    Methods: A systematic search of the published and presented literature was performed to identify phase III trials assessing ICI combination regimens in RCC using search terms 'immune checkpoint inhibitors' AND 'renal cell carcinoma,' AND 'advanced'.
    Results: Six phase III trials showed significant benefits for ICI combinations compared with sunitinib. Nivolumab plus ipilimumab significantly improved overall survival [OS; median, 47.0
    Conclusions: Phase III first-line trials of ICI combinations showed survival benefits compared with a control arm of sunitinib. Global access to these combinations should be made available to patients with advanced RCC.
    Language English
    Publishing date 2022-06-28
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2503443-1
    ISSN 1758-8359 ; 1758-8340
    ISSN (online) 1758-8359
    ISSN 1758-8340
    DOI 10.1177/17588359221108685
    Database MEDical Literature Analysis and Retrieval System OnLINE

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