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Renal Cell Carcinoma
Center of Excellence
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George Yaghmour
Aug 10, 2015
It is really interesting to share this case. Iacovelli and colleagues recently published in European Urology outlines a cohort of 63 consecutive patients who received standard dosages of sunitinib and pazopanib in the front-line setting with the intent of defining those individuals who developed tumor flare. This patient TKI treatment was discontinued due toxicity and confirming Lacovelli, et al papers he experience a significantly larger tumor flare than those discontinuing for stable disease. The higher the growth rate, the shorter the survival. It is really interesting and nice to see in real life practice that discontinuation of antiangiogenic agents may cause an increase in tumor growth rate, which is related to patient survival and consider it as prognostic features. This patient would might benefit of molecular testing of the flare up tissue and be considered for Immunoboosting therapy in setting of trial.
Mark Stevens
Aug 28, 2015
Interesting to see this in RCC - in practice most oncologists experience this phenomenon in NSCLC and TKI therapy transitions. Covering the transition with a PD-1 or CTLA-4 inhibitor in patients with stable or progressing disease seems prudent and relatively inexpensive if the changeover period is < 1 week which is the main "danger" period.
adolfo salinas
Aug 28, 2015
Interesting case.
May 04, 2024
Pending Moderator approval.
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Laurie
Appleby
MS, APRN, BC
George Yaghmour
Aug 10, 2015
Mark Stevens
Aug 28, 2015
adolfo salinas
Aug 28, 2015
May 04, 2024
Pending Moderator approval.