REVIEW ARTICLE Edwin M. Posadas, Robert A. Figlin;ONCOLOGY Vol. 26 No. 3 This article will review the recent advances that form the current framework of therapy for RCC, as well as summarize key areas of progress and innovation in the evolving treatment paradigms for this disease.
SECOND OPINION Elaine T. Lam et al;ONCOLOGY Vol. 25 No. 9 The patient is a 43-year-old man who was initially evaluated at an outside institution for unexplained anemia and who was found to have a large right kidney mass. He underwent a radical nephrectomy for a 19-cm large-cell, poorly differentiated neoplasm.
TEST YOUR IMAGE IQ A mass was found in the left kidney of patient with von Hipple-Lindau Syndrome. You would predict this mass to show which genetic abnormality:
A. Mutation of VHL B. Deletions in chromosome 3 C. Neither A nor B D. Both A and B
TEST YOUR IMAGE IQ Patient's review of systems is negative with the exception of complaints about mild right-sided postero-lateral flank pain. What should be done first:
A. Tell the patient this is a benign cherry angioma and offer electrodesiccation. B. Test for HIV because this lesion could represent bacillary angiomatosis. C. Order a PET scan. D. Perform a urinalysis.
For the first time, the US Food and Drug Administration (FDA) has granted a new oncologic drug product approval for indications for two different cancers simultaneously. The agency approved Sutent (suniti-nib, Pfizer) for the... More »
The Food and Drug Administration (FDA) has approved Nexavar (sorafenib tosylate) tablets for the treatment of patients with advanced renal cell carcinoma. Nexavar, a multikinase inhibitor that has been shown to double... More »
Renal-cell carcinoma (RCC) is curable only in patients presenting with resectable, early-stage disease. Advanced local or metastatic disease carries an approximate 15% 5-year survival rate. However, the natural history of... More »
This supplement to Oncology News International includes 17 reports
on clinical trials of targeted therapies used alone, in combination with chemotherapy,
or in combination with each other in the treatment of non–small-cell... More »
An 85-year-old man was admitted to the hospital with a
cough and shortness of breath of 1 week’s duration and
a fever and increased sputum production for 2 days. His
history included renal cell carcinoma and metastatic renal... More »
This special supplement to Oncology News International includes 28 reports
with updated information on clinical trials investigating capecitabine and other agents in
the treatment of advanced colorectal and breast cancers,... More »
Metastatic renal cell carcinoma is a devastating disease associated
with poor survival. Immunotherapy is the mainstay of treatment, but
response rates are low. The role of cytoreductive surgery in the
presence of metastatic... More »
In this issue of ONCOLOGY,
Chaudhary and Hull succinctly
summarize historical trends and
current thinking regarding the role of
cytoreductive nephrectomy in patients
with metastatic kidney cancer.
Before the era of... More »
It is well known that the RAS (renin-angiotensin system) plays a key role in the modulation of many functions in the body. AngII (angiotensin II) acting on AT1R (type 1 AngII receptor) has a central role in mediating most of the actions of the RAS. However, over the past 10years, several studies have presented evidence for the existence of a new arm of the RAS, namely the ACE (angiotensin-converting enzyme) 2/Ang-(1-7) [angiotensin-(1-7)]/Mas axis. Ang-(1-7) can be produced from AngI or AngII via endo- or carboxy-peptidases respectively. ACE2 appears to play a central role in Ang-(1-7) formation. As described for AngII, Ang-(1-7) also has a broad range of effects in different organs and tissues which goes beyond its initially described cardiovascular and renal actions. Those effects are mediated by Mas and can counter-regulate most of the deleterious effects of AngII. The interaction Ang-(1-7)/Mas regulates different signalling pathways, such as PI3K (phosphoinositide 3-kinase)/AKT
Metastatic renal cell cancer is associated with poor long-term survival and has no cure. Traditional clinical endpoints are best supplemented by patient-reported outcomes designed to assess symptoms and function. Normative data was obtained on the National Comprehensive Cancer Network-Functional Assessment of Cancer Therapy-Kidney Symptom Index (NFKSI) to aid in score interpretation and planning of future trials.|General population data were obtained from 2000 respondents, who completed the 19-item NFKSI-19, as well the SF-36 (Short Form 36-item instrument) and the PROMIS-29 (29-item Patient Reported Outcomes Measurement Information System), both general health status measures. Basic demographic and self-reported comorbidity data were also collected.|The sample was 50% female, 85.7% caucasian, with an equal distribution across age bands from 18 years to 75 years and older. Most respondents (62.8%) had more than a high school education and reported an Eastern Cooperative Oncology Group
Kidneycancer is composed of several bio-histological entities. The most frequent type, clear-cell carcinoma, is not homogenous regarding gene mutations or transcriptomic profiles, but the biologic classifications are not yet mature. Therefore, biologically driven strategies of treatment have not yet been developed in the clinical setting. The choice of first-line agent currently depends on the prognostic criteria published by Motzer et al. [J Clin Oncol 1999;17:2530-2540] and recently by Heng et al. [J Clin Oncol 2009;27:5794-5799], with anti-vascular endothelial growth factor (VEGF) therapies for good- or intermediate-prognosis groups and anti-mammalian target of rapamycin (mTOR) for poor-risk patients. In the past years, biological changes leading to resistance to targeted agents have been widely investigated. Discoveries resulted in the development of second-generation VEGF receptor tyrosine kinase inhibitors, characterized by an improved potency and selectivity. Besides,
This study included a cohort of advanced renal cell carcinoma patients treated with sunitinib. Since resistance to sunitinib may be mediated through angiogenic cytokines other than VEGF, we measured the circulating levels of three pro-angiogenic cytokines: basic fibroblast growth factor (bFGF), hepatocyte growth factor (HGF), and interleukin (IL)-6.|Cytokines were measured at baseline and on the first day of each treatment cycle until progression in 85 advanced kidneycancer patients treated with sunitinib using a quantitative sandwich enzyme immunoassay (ELISA) technique.|Even though no statistically significant differences in the titers of the three cytokines were observed between baseline and the time of progression in the whole patient cohort, in 45.3, 46.6, and 37.3% of the patients a more than 50% increase between baseline and the time of progression was shown in circulating IL-6, bFGF, and HGF, respectively. Furthermore, this increase was more than 100% in 37.3, 44, and 30.6%
p21-activated kinase (PAK)7 (also known as PAK5) is a member of the group B PAK family of serine/threonine protein kinases, which are effectors of the small GTPases Rac and CDC42. PAK7 can promote neurite outgrowth, induce microtubule stabilization, and activate cell survival signaling pathways. However, the role of PAK7 in cancer is still poorly understood. Here, we showed that PAK7 expression was upregulated in different gastric cancer cell lines and gastric cancer tissues, as compared with human embryonic kidney 293 cells and adjacent normal tissues, respectively. The results suggested that PAK7 expression was related to gastric cancer progression. Thus, we employed lentivirus-mediated small interfering RNA to inhibit PAK7 expression, to investigate the role of PAK7 in human gastric carcinogenesis. RNA interference efficiently downregulated expression of PAK7 in SGC-7901 and MGC-803 cells at both mRNA and protein levels. Knockdown of PAK7 inhibited human gastric cancer cell
A 48-year-old woman presents with history of hematuria and abdominal pain spanning several days. The patient does not have any previous tumor history. Radiological evaluation revealed the presence of a large mass in the upper pole of the right kidney. Right nephrectomy was performed.
CancerNetwork speaks with Dr. Michael Atkins, who has extensive clinical experience in kidney cancer and development of various new treatments, and is presenting this weekend during the renal cancer translational science session at the American Society of Clinical Oncology 2012 Genitourinary Cancers Symposium.
Primary Care Can't Thrive Without Nurse Practitioners Courtney H. Lyder, ND, May 17, 2013 With a projected shortfall of primary-care physicians, it's time for alternate solutions to patient care. Nurse practitioners are one logical remedy.
A 2-month history of cough sent a 62-year-old woman for medical... 
A 45-year-old man complained of blood in his urine. The... 
A 43-year-old woman was admitted to the hospital with... 
An 85-year-old man was admitted to the hospital with a... 
A 42-year-old woman came to the emergency department because... 
A 45-year-old man presented to the emergency... 
he sudden appearance of an asymptomatic, 6 x 4.5-mm,... 
A 48-year-old woman presents with history of hematuria and abdominal pain spanning several days. The patient does not have any previous tumor history. Radiological evaluation revealed the presence of a large mass in the upper pole of the right kidney. Right nephrectomy was performed.
CancerNetwork speaks with Dr. Michael Atkins, who has extensive clinical experience in kidney cancer and development of various new treatments, and is presenting this weekend during the renal cancer translational science session at the American Society of Clinical Oncology 2012 Genitourinary Cancers Symposium.
