Challenges in kidney cancers
14 Nov 2015 - Joel Vega
There are notable gains in the diagnosis of uncommon renal tumours but patients need to be enrolled in clinical studies or referred to high-volume centres for researchers to reach more meaningful outcomes.
“Non-clear cell renal cell carcinoma (nccRCC) should histologically and molecularly be classified in a much more subtle way in future pathological reports,” said Prof. Susanne Osanto (NL) during a session on rare kidney cancers. Osanto gave a comprehensive overview of current studies being done on nccRCC and noted the glimmers of hope in some ongoing research.
“There is evidence of activity for existing VEGFR and mTOR inhibitors in non-clear cell RCC (papillary),” she added while noting pivotal Phase 3 studies involving temsirolimus and in Expanded Access Programmes (EAPS) and case studies. In EAPs, for example, Osanto mentioned that TKI and mTOR inhibitors showed efficacy.
Moreover, there are prospective nccRCC trials which support activity of established targeted agents in papillary RCC.
Osanto’s obervations prompted session chair U. Capitanio (IT) to comment that this implies that patients with these uncommon kidney tumours need to be referred to high-volume centres, to which Osanto added there is actually a need for larger studies.
“Pathways targeting drugs and combinations need to be further explored prospectively in larger global trials or basket trials of cancers sharing a genetic abnormality,” she said.
The session also looked into issues such as the role of radiology and how radiotherapy can support the treatment for patients with nccRCC and hereditary cancers.
Medical oncologist G. Malouf (FR) noted that rare kidney cancers represent a wide range of diseases with distinct clinico-pathological features.
“Molecular characterisation of these tumours is urgently needed,” Malouf said while adding that international collaborations are necessary to study these so-called orphan tumours.