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  1. 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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    Zs.A 6967: Show issues Location:
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  2. 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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  3. Article ; Online: [No title information]

    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 17, Page(s) E601–E607

    Title translation Percées dans la prise en charge de l’hypernéphrome.
    MeSH term(s) Humans ; Kidney Neoplasms/therapy ; Carcinoma, Renal Cell/therapy
    Language French
    Publishing date 2024-05-05
    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-f
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  4. 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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    Zs.A 4305: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Trends of Utilization of Systemic Therapies for Metastatic Renal Cell Carcinoma in the Canadian Health Care System.

    Cardenas, Luisa M / Ghosh, Sunita / Finelli, Antonio / Wood, Lori / Kollmannsberger, Christian / Basappa, Naveen / Graham, Jeffrey / Heng, Daniel / Bjarnason, Georg / Soulières, Denis / Bossé, Dominick / Castonguay, Vincent / Saleh, Ramy / Tanguay, Simon / Bhindi, Bimal / Breau, Rodney H / Pouliot, Frederic / Lalani, Aly-Khan A

    JCO global oncology

    2023  Volume 9, Page(s) e2300271

    Abstract: Purpose: Standard-of-care therapies for metastatic renal cell carcinoma (mRCC) have greatly evolved. However, the availability of emerging options in global health care systems can vary. We sought to describe the integration and usage of systemic ... ...

    Abstract Purpose: Standard-of-care therapies for metastatic renal cell carcinoma (mRCC) have greatly evolved. However, the availability of emerging options in global health care systems can vary. We sought to describe the integration and usage of systemic therapies for mRCC in Canada since 2011.
    Methods: We included patients with mRCC enrolled in the Canadian Kidney Cancer Information System, a prospective cohort of patients from 14 Canadian academic centers, who received systemic therapy from January 1, 2011, to December 31, 2021. Patients were stratified by treatment era (cohort 1: 2011-2015, cohort 2: 2016-2021). Stacked bar charts were used to present treatment proportions; Sankey diagrams were used to show the evolution of treatment sequencing between the two cohorts.
    Results: Four thousand one hundred seven patients were diagnosed with mRCC, of whom 2,752 (67%) received systemic therapy. Among these patients, mean age was 64 years, 74% were male, 75% had clear cell histology, and International Metastatic RCC Database Consortium risk classification was favorable, intermediate, and poor in 16%, 56%, and 28%, respectively. Utilization of immune checkpoint inhibition (ICI)-based treatments has increased in Canada and reflects global and local patterns of approval and adoption. The use of therapies after doublet ICI has mostly shifted toward vascular endothelial growth factor-tyrosine kinase inhibitors (VEGF-TKIs) that were previously used in first line with subsequent treatments reflecting approved and available agents after previous VEGF-TKI. Clinical trial participation among patients who received systemic therapy was 18% in first, 21% in second, and 24% in third line.
    Conclusion: In Canada's publicly funded health care system, availability of standard mRCC therapies broadly reflects access from government-funded clinical trials and compassionate access program sources. In an evolving therapeutic landscape, ongoing advocacy is required to continue to facilitate patient access to efficacious therapies.
    MeSH term(s) Humans ; Male ; Middle Aged ; Female ; Carcinoma, Renal Cell/drug therapy ; Kidney Neoplasms/drug therapy ; Vascular Endothelial Growth Factor A/therapeutic use ; Prospective Studies ; Canada ; Delivery of Health Care
    Chemical Substances Vascular Endothelial Growth Factor A
    Language English
    Publishing date 2023-11-22
    Publishing country United States
    Document type Journal Article
    ISSN 2687-8941
    ISSN (online) 2687-8941
    DOI 10.1200/GO.23.00271
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  6. Article: Adjuvant therapy for renal cell carcinoma: 2023 Canadian Kidney Cancer Forum consensus statement.

    Lalani, Aly-Khan A / Kapoor, Anil / Basappa, Naveen S / Bhindi, Bimal / Bjarnason, Georg A / Bosse, Dominick / Breau, Rodney H / Canil, Christina M / Cardenas, Luisa M / Castonguay, Vincent / Chavez-Munoz, Claudia / Chu, William / Dudani, Shaan / Graham, Jeffrey / Heng, Daniel Y C / Kollmannsberger, Christian / Lattouf, Jean-Baptiste / Morgan, Scott / Reaume, M Neil /
    Richard, Patrick O / Swaminath, Anand / Tanguay, Simon / Wood, Lori A / Lavallée, Luke T

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

    2023  Volume 17, Issue 5, Page(s) E154–E163

    Abstract: Introduction: Several recent randomized trials evaluated the impact of adjuvant immune checkpoint inhibitor (ICI)-based therapy on post-surgical outcomes in renal cell carcinoma (RCC), with disparate results. The objective of this consensus statement is ...

    Abstract Introduction: Several recent randomized trials evaluated the impact of adjuvant immune checkpoint inhibitor (ICI)-based therapy on post-surgical outcomes in renal cell carcinoma (RCC), with disparate results. The objective of this consensus statement is to provide data-driven guidance regarding the use of ICIs after complete resection of clear-cell RCC in a Canadian context.
    Methods: An expert panel of genitourinary medical oncologists, urologic oncologists, and radiation oncologists with expertise in RCC management was convened in a dedicated session during the 2022 Canadian Kidney Cancer Forum in Toronto, Canada. Topic statements on the management of patients after surgery for RCC, including counselling, risk stratification, indications for medical oncology referral, appropriate followup, eligibility and management for adjuvant ICIs, as well as treatment options for patients with recurrence who received adjuvant immunotherapy, were discussed. Participants were asked to vote if they agreed or disagreed with each statement. Consensus was achieved if greater than 75% of participants agreed with the topic statement.
    Results: A total of 22 RCC experts voted on 14 statements. Consensus was achieved on all topic statements. The panel felt patients with clear-cell RCC at increased risk of recurrence after surgery, as per the Keynote-564 group definitions, should be counselled about recurrence risk by a urologist, should be informed about the potential role of adjuvant ICI systemic therapy, and be offered referral to discuss risks and benefits with a medical oncologist. The panel felt that one year of pembrolizumab is currently the only regimen that should be considered if adjuvant therapy is selected. Panelists emphasized current opinions are based on disease-free survival given the available results. Significant uncertainty regarding the benefit and harms of adjuvant therapy remains, primarily due to a lack of consistent benefit observed across similar trials of adjuvant ICI-based therapies and immature overall survival (OS) data.
    Conclusions: This consensus document provides guidance from Canadian RCC experts regarding the potential role of ICI-based adjuvant systemic therapy after surgery. This rapidly evolving field requires frequent evidence-based re-evaluation.
    Language English
    Publishing date 2023-04-25
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2431403-1
    ISSN 1911-6470
    ISSN 1911-6470
    DOI 10.5489/cuaj.8381
    Database MEDical Literature Analysis and Retrieval System OnLINE

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