scholarly journals Outcomes of Radiotherapy Plus Immunotherapy in Metastatic Renal Cell Carcinoma: Results from The Canadian Kidney Cancer Information System

2022 ◽  
pp. 100899
Author(s):  
Eric K. Nguyen ◽  
Aly-Khan A. Lalani ◽  
Sunita Ghosh ◽  
Naveen S. Basappa ◽  
Anil Kapoor ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Information System ◽  
Cell Carcinoma ◽  
Kidney Cancer ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Cancer Information

Real-Word Experience of Cabozantinib in Metastatic Renal Cell Carcinoma (mRCC): Results from the Canadian Kidney Cancer information system (CKCis)

Kidney Cancer ◽  
2021 ◽  
pp. 1-9
Author(s):  
Hanbo Zhang ◽  
Naveen S. Basappa ◽  
Sunita Ghosh ◽  
Isaiah Joy ◽  
Aly-Khan A. Lalani ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Information System ◽  
Cell Carcinoma ◽  
Kidney Cancer ◽  
Metastatic Renal Cell Carcinoma ◽  
Real World ◽  
Renal Cell ◽  
Multivariable Analysis ◽  
Cancer Information ◽  
Second Line

Background: Cabozantinib is an oral multitargeted tyrosine kinase inhibitor (TKI) that has demonstrated efficacy in metastatic renal-cell carcinoma (mRCC) randomized trials. Objective: To explore the real-world effectiveness of cabozantinib in pretreated patients with mRCC, including patients who progressed on immune-oncology checkpoint inhibitor (ICI) therapy. Methods: Using the Canadian Kidney Cancer information system (CKCis), patients with mRCC treated with cabozantinib monotherapy as second-line or later from January 1, 2011 to September 1, 2019 were identified. Patients were stratified based on line of cabozantinib received. We reported overall survival (OS), time to treatment failure (TTF) and disease control rate (DCR). Prognostic variables were analyzed using multivariable analysis. Results: 157 patients received cabozantinib (median TTF 8.0 months; median OS 15.8 months): 37 (24%) in the second line (median TTF 10.4 months; median OS 18.9 months) 66 (42%) in third line (median TTF 5.9 months; median OS 13.3 months) and 54 (34%) in either 4th or 5th line (median TTF 9.4 months; median OS 16.8 months). One hundred sixteen patients (74%) received cabozantinib after prior ICI therapy (median TTF of 7.6 months; median OS of 15.8 months). DCR in all patients was 63% with 46%, 65% and 72% in 2nd line, 3rd line and 4th/5th line patients respectively. DCR in patients who received cabozantinib after prior ICI therapy was 64%. Conclusions: Cabozantinib is effective in a real-world, unselected population of mRCC patients, including in those who have progressed on prior ICI therapy, and in those exposed to multiple lines of therapy.

scholarly journals Prognostic impact of paraneoplastic syndromes on patients with non-metastatic renal cell carcinoma undergoing surgery: Results from Canadian Kidney Cancer information system

2020 ◽  
Vol 15 (4) ◽  
Author(s):  
Ryan Sun ◽  
Rodney H. Breau ◽  
Ranjeeta Mallick ◽  
Simon Tanguay ◽  
Frederic Pouliot ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Information System ◽  
Cell Carcinoma ◽  
Kidney Cancer ◽  
Renal Cell ◽  
Paraneoplastic Syndromes ◽  
Cancer Information ◽  
Prognostic Impact ◽  
Kaplan Meier ◽  
Metastatic Rcc

Introduction: The impact of paraneoplastic syndromes (PNS) on survival in patients with renal cell carcinoma (RCC) is uncertain. This study was conducted to analyze the association of PNS with recurrence and survival of patients with non-metastatic RCC undergoing nephrectomy. Methods: The Canadian Kidney Cancer information system is a multi-institutional cohort of patients started in January 2011. Patients with nephrectomy for non-metastatic RCC were identified. PNS included anemia, polycythemia, hypercalcemia, and weight loss. Associations between PNS and recurrence or death were assessed using Kaplan-Meier curves and multivariable analysis. Results: Of 4337 patients, 1314 (30.3%) had evidence of one or more PNS. Patients with PNS, were older, had higher comorbidity, and had more advanced clinical and pathological tumor characteristics as compared to patients without PNS (all p<0.05). Kaplan-Meier five-year estimated recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were significantly worse in patients with PNS (63.7%, 84.3%, and 79.6%, respectively for patients with PNS vs. 73.9%, 90.8%, and 90.1%, respectively for patients without PNS, all p<0.005). On univariable analysis, presence of PNS increased risk of recurrence (hazard ratio [HR] 1.67, 95% confidence interval [CI] 1.48–1.90, p<0.0001) and cancer-related death (HR 1.85, 95% CI 1.34–2.54, p=0.0002). Adjusting for known prognostic factors, PNS was not associated with recurrence or survival. Conclusions: In non-metastatic RCC patients undergoing surgery, presence of PNS is associated with older age, higher Charlson comorbidity index score, advanced tumor stage, and aggressive tumor histology. Following surgery, baseline PNS is not strongly independently associated with recurrence or death.

scholarly journals Positive surgical margins during partial nephrectomy for renal cell carcinoma: Results from Canadian Kidney Cancer information system (CKCis) collaborative

2017 ◽  
Vol 11 (6) ◽  
pp. 182 ◽  
Author(s):  
Rahul K. Bansal ◽  
Simon Tanguay ◽  
Antonio Finelli ◽  
Ricardo Rendon ◽  
Ronald B. Moore ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Cell Carcinoma ◽  
Information System ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Kidney Cancer ◽  
Renal Cell ◽  
Tumour Size ◽  
Surgical Margin ◽  
Cancer Information

Introduction: We sought to determine the incidence, risk factors, and prognosis for patients with positive surgical margin (PSM) during partial nephrectomy (PN) for renal cell carcinoma (RCC).Methods: From the Canadian Kidney Cancer information system (CKCis) database, a historical cohort of PN patients with PSM were identified and compared to negative surgical margin (NSM). Risk factors for PSM were examined through multivariable logistic regression. Kaplan-Meier curves were used to compare progression- free survival.Results: Of 1103 patients, 972 (88.1%), 71 (6.4%), and 60 (5.4%) had NSM, PSM, and unknown status, respectively. Median patient age and tumour size were 61 years and 3.0 cm for both groups. From multivariable analysis, pathological stage ≥T3 (odds ratio [OR] 2.51; 95% confidence interval [CI] 1.13–5.60) and Fuhrman grade 4 (OR 5.35; 95% CI 1.11‒25.72) were associated with PSM, whereas age, operative technique, and tumour size were not. Forty-nine (5.0%) patients from the NSM cohort and seven (9.9%) from the PSM cohort had a local/systemic progression of disease (adjusted hazard ratio [HR] 1.4; 95% CI 0.6‒3.6). There were three (0.3%) cancer-related deaths in the NSM group and none in the PSM group. After median followup of 19 (interquartile range [IQR] 5‒42) and 15 (IQR 7–30) months, 855 (91.4%) and 61 (89.7%) patients were alive in the NSM and PSM groups, respectively.Conclusions: PSM occurred in 6.4% of PNs performed for RCC in this pan-Canadian cohort. Higher stage and grade are associated with a higher risk of positive margin. The small association between a PSM and progression suggests that complete nephrectomy is not necessary in patients with a PSM. The main study limitations are lack of nephrometry score and possible reporting bias.

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