Continuing Education
for Urology & GU Oncology Clinicians
Washington, DC (UroToday.com) As part of the SUO-CTC session on upcoming surgically relevant clinical trials in renal cell carcinoma (RCC), Dr. Ithaar Derweesh discussed the Ischemia Trial, assessing elective partial vs radical nephrectomy for tumors with increased oncologic potential. There is equipoise for this trial, as noted by Dr. Derweesh, considering that NCCN guidelines suggest that for stage II/III tumors a partial nephrectomy is reasonable if clinically indicated. The AUA guidelines have well defined (restricted) criteria for selecting patients for a radical nephrectomy, including those with an aggressive appearing tumor, no pre-existing CKD/proteinuria and a normal contralateral kidney that can provide a new baseline GFR > 45 ml/min/1.73m2.
Non-Accredited
Washington, DC (UroToday.com) Dr. Steven Campbell reviewed the controversial topic of nephron-sparing surgery for cT1b-T2 renal masses. Partial nephrectomy (PN) is recommended for small renal masses (cT1a) when surgically managed, and is generally preferred for patients with pre-existing chronic kidney disease (CKD) and familial renal cell carcinoma (RCC). For patients with larger localized renal masses (cT1b-T2), the optimal management paradigm is less clear.
Non-Accredited
Washington, DC (UroToday.com) At the kidney cancer session at SUO 2019, Dr. Joshua Lang discussed the future of predictive biomarkers in renal cell carcinoma (RCC). Indeed, this is an evolving therapeutic landscape, with combination therapies as 1st line options for metastatic RCC including nivolumab plus ipilimumab and axitinib plus pembrolizumab. Single-agent options depend on disease risk scores and include cabozantinib and pazopanib.
Non-Accredited
Washington, DC (UroToday.com) The SUO-CTC session included a sub-session highlighting upcoming surgically relevant clinical trials, including SWOG 1931, the next cytoreductive trial presented by Dr. Hyung Kim. SWOG 1931 will be a phase III trial of immunotherapy-based combination therapy with or without cytoreductive nephrectomy for patients with metastatic renal cell carcinoma (RCC).
Non-Accredited
Washington, DC (UroToday.com) One of the challenges of advanced renal cell carcinoma is its potential to literally cross boundaries between specialties, extending from the site of origin in the kidney via the vasculature into the realm of vascular, hepatic, and cardiac surgeons via the inferior vena cava and occasionally compromising the colon, spleen, and pancreas.
Non-Accredited