March brings for a needed reminder of kidney cancer’s impact. In 2020, renal cell carcinoma (RCC) impacted 75,000 people, of which 14,000 died. However, there is rapid and innovative progress in understanding this cancer’s biology, as well as improved diagnostics and treatments.
“In the year 2000, there were really one or two cytokine therapies that were viable options to treat this disease in the metastatic setting,” Sarah Psutka, an Assistant Professor of Medicine at the University of Washington and Seattle Cancer Care Alliance (SCCA), explains. “Now, we have a host of therapeutic tools, from tyrosine kinase inhibitors and immunotherapies to checkpoint inhibitors.”
Typically, RCC patients come in for a scan related to another health condition but leave with an unexpected cancer diagnosis. This starts a discussion between them and their oncologist about the appropriate therapeutics and potential surgery to treat and/or manage their condition.
There are ongoing treatment advancements in immune-checkpoint inhibitors, co-stimulatory pathway agonists, modified cytokine therapies, metabolic pathway modulators, adoptive cell therapies, therapeutic vaccines, and precision immunotherapy to target kidney cancer-specific antigens. Clinical trials are critical in not only identifying the efficacy of these therapeutics but also noting their toxicities and the impact on the patient’s quality of life.
Pressing questions in the field include, “How do we sequence these therapies, how do we choose?” Dr. Psutak shares. “How do we salvage somebody who progresses through one therapy, how do we know what the right next therapy is to go to?”
“I hope we can improve the understanding of clinical trials and the importance of enrolling on these studies to not only improve outcomes in patients currently diagnosed with kidney cancer but also to help future patients,” Shuchi Gulati, an Assistant Professor of Medicine at the University of Cincinnati, explains.
In particular, immune-based therapies play a critical role in increasing the treatment options available for patients with RCC.
“Patients are living so much longer than previously compared with the 1990s and 2000s. We now struggle with questions regarding treatment selection between many potent, effective choices and not just hoping that a patient will benefit. I am grateful for the patient advocates who continue to shape the clinical trials of today so that the lives of our patients will continue to improve,” Benjamin Maughan, an Assistant Professor of Medicine at the University of Utah, shares.
The field of oncology is changing on a day-to-day basis. Please visit Binaytara Foundation’s education portal https://education.binayfoundation.org/ to learn more about the advances in the field.