Explore the vast range of titles available.

The approval of immunotherapeutic agents and immunotherapy-based combination strategies in recent years has revolutionized the treatment of patients with advanced renal cell carcinoma (aRCC). Nivolumab, a programmed death 1 (PD-1) immune checkpoint inhibitor monoclonal antibody, was approved as monotherapy in 2015 for aRCC after treatment with a VEGF-targeting agent. In April 2018, the combination of nivolumab and ipilimumab, a CTLA-4 inhibitor, was approved for intermediate- and poor-risk, previously untreated patients with aRCC. Then, in 2019, combinations therapies consisting of pembrolizumab (anti-PD-1) or avelumab (anti-PD-ligand (L) 1) with axitinib (a VEGF receptor tyrosine kinase inhibitor) were also approved to treat aRCC and are likely to produce dramatic shifts in the therapeutic landscape. To address the rapid advances in immunotherapy options for patients with aRCC, the Society for Immunotherapy of Cancer (SITC) reconvened its Cancer Immunotherapy Guidelines (CIG) Renal Cell Carcinoma Subcommittee and tasked it with generating updated consensus recommendations for the treatment of patients with this disease.

PurposeTo ascertain renal cell carcinoma (RCC) financial toxicity on COVID-19 during the COVID-19 crisis as patients are struggling with therapeutic and financial implications.MethodsAn online survey was conducted from March 22 to March 25, 2020. It included baseline demographic, clinicopathologic, treatment-related information, anxiety levels related to COVID-19, questions related to financial concerns about COVID-19 as well as the validated 11-item COST measure.ResultsFive-hundred-and-thirty-nine patients (39%:58% male:female) from 14 countries responded. 23% of the patients did not feel in control of their financial situation but 8% reported being very satisfied with their finances. The median COST score was 21.5 (range 1–44). Metastatic patients who have not started systemic therapy had a COST score (19.8 range 2–41) versus patients on oral systemic therapy had a COST score (23.9 range 4–44). Patients in follow-up after surgery had a median COST score at 20.8 (range 1–40). A low COST scores correlated (p < 0.001) were female gender (r = 0.108), younger age (r = 0.210), urban living situation (r = 0.68), a lower educational level (r = 0.155), lower income (r = 0.165), higher anxiety about acquiring COVID-19 (r = 0.198), having metastatic disease (r = 0.073) and a higher distress score about cancer progression (r = 0.224).ConclusionOur data highlight severe financial impact of COVID-19. Acknowledging financial hardship and thorough counseling of cancer patients should be part of the conversation during the pandemic. Treatment and surveillance of RCC patients might have to be adjusted to contemplate financial and medical needs.

With multiple PD-(L)1 inhibitors approved across dozens of indications by the US Food and Drug Administration, the number of patients exposed to these agents in adjuvant, first-line metastatic, second-line metastatic, and refractory treatment settings is increasing rapidly. Although some patients will experience durable benefit, many have either no clinical response or see their disease progress following an initial response to therapy. There is a significant need to identify therapeutic approaches to overcome resistance and confer clinical benefits for these patients. PD-1 pathway blockade has the longest history of use in melanoma, non-small cell lung cancer (NSCLC), and renal cell carcinoma (RCC). Therefore, these settings also have the most extensive clinical experience with resistance. In 2021, six non-profit organizations representing patients with these diseases undertook a year-long effort, culminating in a 2-day workshop (including academic, industry, and regulatory participants) to understand the challenges associated with developing effective therapies for patients previously exposed to anti-PD-(L)1 agents and outline recommendations for designing clinical trials in this setting. This manuscript presents key discussion themes and positions reached through this effort, with a specific focus on the topics of eligibility criteria, comparators, and endpoints, as well as tumor-specific trial design options for combination therapies designed to treat patients with melanoma, NSCLC, or RCC after prior PD-(L)1 pathway blockade.

Immune checkpoint therapy (ICI) has enabled induction of remission in advanced renal cell carcinoma RCC. ICI toxicities can persist as chronic health conditions. We developed a patient survey to assess changes in medical comorbidities after ICI. The survey was developed by the Kidney Cancer Research Alliance (KCCure), with multidisciplinary representation from urologic surgeons, medical oncologists, and patient advocates. The survey was broadcast between July 2022 and September 2022 to patients via website, mailing lists, and social media platforms. Patient perspective on changes to any medical conditions were evaluated in the survey questionnaire. Of 1062 patients that responded, 399 were self-identified as being metastatic and 289 reported to be treated with ICI. Eighty-five percent of respondents were from the United States. The most common conditions noted were thyroid dysfunction in 80 patients, hypertension in 50 patients, chronic kidney disease in 23 patients, heart disease in 10 patients, and diabetes mellitus (DM) in 13 patients. Immune disorders developed in 26 (9%) patients. The limitations are the survey had minimal participation from minority populations. Multiple medical conditions were noted to either emerge or worsen as a result of ICI-based therapies in RCC. Awareness of this information as a starting point should stimulate the development of survivorship programs for renal cancer. A survey of patients with advanced kidney cancer showed that some medical conditions such as thyroid dysfunction, hypertension, heart and kidney disease, DM, and immune conditions were newly diagnosed and/or persisted after immune therapy.

Immune checkpoint therapy (ICI) has enabled induction of remission in advanced renal cell carcinoma RCC. ICI toxicities can persist as chronic health conditions. We developed a patient survey to assess changes in medical comorbidities after ICI. The survey was developed by the Kidney Cancer Research Alliance (KCCure), with multidisciplinary representation from urologic surgeons, medical oncologists, and patient advocates. The survey was broadcast between July 2022 and September 2022 to patients via website, mailing lists, and social media platforms. Patient perspective on changes to any medical conditions were evaluated in the survey questionnaire. Of 1062 patients that responded, 399 were self-identified as being metastatic and 289 reported to be treated with ICI. Eighty-five percent of respondents were from the United States. The most common conditions noted were thyroid dysfunction in 80 patients, hypertension in 50 patients, chronic kidney disease in 23 patients, heart disease in 10 patients, and diabetes mellitus (DM) in 13 patients. Immune disorders developed in 26 (9%) patients. The limitations are the survey had minimal participation from minority populations. Multiple medical conditions were noted to either emerge or worsen as a result of ICI-based therapies in RCC. Awareness of this information as a starting point should stimulate the development of survivorship programs for renal cancer. A survey of patients with advanced kidney cancer showed that some medical conditions such as thyroid dysfunction, hypertension, heart and kidney disease, DM, and immune conditions were newly diagnosed and/or persisted after immune therapy.

Many patients diagnosed with cancer adopt dietary changes and supplement use, and a growing body of evidence suggests that such modifications can affect outcomes to cancer therapy. We sought to assess the prevalence of these practices and the surrounding physician-patient dialogue among patients with metastatic renal cell carcinoma. An online survey was administered by Kidney Cancer Research Alliance (KCCure), interrogating dietary modification patterns, supplement usage, out-of-pocket expenditure related to supplements, and patients’ views toward alternative medicine practices. Patients with metastatic renal cell carcinoma receiving combination therapy were actively solicited. In total, 289 unique responses were collected. The most common first-line treatments were nivolumab/ipilimumab (32.4%) and axitinib/pembrolizumab (13.1%). Within the cohort, 147 (50.9%) started using supplements following diagnosis of renal cell carcinoma; the most utilized supplements were probiotics, cannabidiol (CBD) oil/marijuana, and Vitamin C, reported by 70 (47.6%), 61 (41.4%), and 54 (36.7%), respectively. Dietary modifications following cancer diagnosis were reported by 101 (34.9%) respondents, of which 19.8% followed the Mediterranean diet and 18.8% adopted a ketogenic diet. Most respondents (71.3%) noted that they consistently report supplement usage to their physicians. A substantial proportion of patients with metastatic renal cell carcinoma utilize dietary modification and supplements as an adjunct to antineoplastic therapy. Considering the widespread adoption of these practices and the reported effects on cancer treatment, it is crucial for healthcare providers to engage in discussions with patients regarding supplement use.