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Renal Cell Carcinoma
Center of Excellence
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Recommendations for this individual are to obtain a drug like sunitinib to control disease growth, as this will provide her the highest chance of benefit. An older alternative, which has provided more modest benefit, is the combination of gemcitabine 600mg/m2 IV every 2 weeks and capecitabine 1000-1250mg/m2 by mouth daily 10 days on and 4 days off. Cytoreductive nephrectomy or any surgical intervention is unlikely to help, as the major cause of morbidity and mortality in her case will be her metastatic disease, and disease course is unlikely to be favorably altered by surgery.
Laszlo Torday
Feb 24, 2020
Just as an add-on to previous comments, considering the fact of the unavailability of any kind of IO+TKI/IO combo (these are probably just dreams there, like here in Hungary, right now...), a good VEGFR-TKI would be the best choice for the patient. And on the basis of toxicity profiles, and connected side effect management issues, probably not the sunitinib is the best option but tivozantinib, or axitinib, or pazopanib. And we should not forget the good old sorafenib which could also do a satisfactory job, if managed properly...
Ismail Abdelhafeez
Feb 27, 2020
If sunitinib unaffordable... supportive management !
Apr 18, 2024
Pending Moderator approval.
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María Marta Bader
Feb 21, 2020
Eric Jonasch MD
Feb 24, 2020
Laszlo Torday
Feb 24, 2020
Ismail Abdelhafeez
Feb 27, 2020
Apr 18, 2024
Pending Moderator approval.