Renal Cell Carcinoma and the General Medical Oncologist: Where We Are and Where We’re HeadedSystemic treatment of nonclear cell renal cancer
2:06 minutes.
TRANSCRIPTION:
DR STADLER: Nonclear cell cancer is a bit of a wastebasket, and I think what’s important, especially for the community practitioner, is that this does not represent one entity. The nonclear cell group includes some patients who often — but not always — have a good prognosis, such as chromophobe tumors, and others that have absolutely horrid prognosis, such as some of our translocation tumors or our collecting duct tumors. I think it’s important to recognize that this is not one disease — it’s several diseases. DR LOVE: From a practical perspective, how do you approach these patients? DR STADLER: I think that from a practical standpoint, the collecting duct tumors are a little bit different and are probably more closely related to urothelial cancers. Those are the cancers that we treat with cytotoxic therapies, similar to urothelial cancers. They sometimes respond but generally only have short-lived responses. The others we tend to treat with the same agents. We know we occasionally see responses. In general, the response rate is lower, the benefit seems to be less, but we basically use what’s available. DR LOVE: Bob, any thoughts about this issue? DR FIGLIN: I think it’s an unmet medical need. I think that, as Walter pointed out, this is a basket of diseases. We’re trying to get at them from the perspective of their biology and what’s targetable. I think that we all see a handful of them on a regular basis, but we really need a consortium approach to the management of the nonclear cell histology, which has not really been established. But generally what I would do in this situation is exactly what was described. I would use either a TKI or mTOR inhibitor, and I wouldn’t be able to choose between which one. |