62 Kidney Cancer Journal T A B L E O F C O N T E N T S Connecting More Dots in Kidney Cancer: Updates on Radiation Therapy, Optimal Dosing Schedules for VEGF Blockade t has always been the aim of the Kidney Cancer Journal to cover the broadest spectrum of topics related to all aspects of managing renal cell carcinoma (RCC). When I was asked to serve as Guest Editor, I knew that this issue of the journal would be no exception. The assortment of articles attests to how our field is rapidly evolving— whether it is new information emerging from the 2017 meeting of the European Society of Medical Oncology (ESMO) or updates from our authors on changing standards in clinical practice or new results from the bench with translational impact. This year’s ESMO scientific sessions presented some pivotal information on key issues with potential translational impact, including the combination of immunotherapy and targeted therapy, and the sequence of sunitinib and nephrectomy. These findings, notably an update on the Checkmate 214 trial and the SURTIME trial, are reviewed in this issue of the Kidney Cancer Journal on Pages 65 and 82, in addition to other results from ESMO. If you follow the medical literature as closely as I do, you may be surprised at how the latest studies have not only more pointedly addressed long-standing controversies in RCC but go further—approaching a consensus that tends to debunk some of the myths surrounding practice standards. A case in point—our content on the safety and efficacy of stereotactic body radiation therapy (SBRT) for RCC, both primary and metastatic. In terms of our knowledge about and application of this technique, we are light years away from the 1950s when a Swedish neurosurgeon first described single-dose ablative radiotherapy delivered to brain lesions. The revolutionary development concerns the way this principle has been extrapolated to the stereotactic delivery of severely hypofractionated treatments to body targets, including kidney, either primary or metastatic, cranial and extracranial. And yet, the myth has lingered that such application in RCC is limited by perceived radioresistance to conventional fractionation. If this is still your perception (a misconception, I might add) then review the article by Raquib Hannan, MD, on how such resistance can be overcome in many clinical settings, thus sparing many patients from nephrectomy, especially those who are poor surgical candidates. One of the areas that has long been a focus of my research is the optimal dosing schedule for sunitinib and efforts to prolong exposure to the drug Editorial Mission The purpose of Kidney Cancer Journal is to serve as a comprehensive resource of information for physicians regarding advances in the diagnosis and treatment of renal cell carcinoma. Content of the journal focuses on the impact of translational research in oncology and urology and also provides a forum for cancer patient advocacy. Kidney Cancer Journal is circulated to medical oncologists, hematologist-oncologists, and urologists. Editor-in-Chief Robert A. Figlin, MD, FACP Steven Spielberg Family Chair in Hematology Oncology Professor of Medicine and Biomedical Sciences Director, Division of Hematology Oncology Deputy Director, Samuel Oschin Comprehensive Cancer Institute Cedars-Sinai Medical Center Medical Advisory Board Michael B. Atkins, MD Deputy Director Lombardi Comprehensive Cancer Center Professor of Oncology and Medicine, Georgetown University Medical Center Washington, DC Ronald M. Bukowski, MD Emeritus Staff & Consultant CCF Taussig Cancer Center Professor of Medicine CCF Lerner College of Medicine of CWRU Cleveland, Ohio Robert J. Motzer, MD Attending Physician Memorial Sloan-Kettering Cancer Center New York, NY Christopher G. Wood, MD, FACS Douglas E. Johnson, MD Professorship Professor & Deputy Chairman Department of Urology M.D. Anderson Cancer Center Houston, Texas Nurse Advisory Board Nancy Moldawer, RN, MSN Nursing Director Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute Los Angeles, California Laura Wood, RN, MSN, OCN Renal Cancer Research Coordinator Cleveland Clinic Taussig Cancer Center Cleveland, Ohio Patient Advocate William P. Bro Chief Executive Officer Kidney Cancer Association Publishing Staff Stu Chapman, Executive Editor Jenny Chapman, Director, Business Development Gloria Catalano, Production Director Michael McClain, Design Director Business and Administration Office 333 E. 75th Street, Suite 5D New York, NY 10021 Editorial Offices Genitourinary Publishing 2557 Tulip Street Sarasota, FL 34239 Tel: (516) 356-5006 © Copyright 2016 Genitourinary Publishing. All rights reserved. None of the contents may be reproduced in any form without the permission of the publisher. About the Cover Artist's depiction of a targeted radiation beam destroying a malignant tumor. Definitive, high-dose-per-fraction stereotactic radiation is having a sharp impact as an option for a growing population of kidney cancer patients. (Copyright ©, Science Source) 64 Journal Club 65 Medical Intelligence 66 Optimizing Sunitinib Dosing: Balancing Efficacy and Tolerability 72 Stereotactic Ablative Radiation for RCC: Novel Paradigms Emerge as the Myth of Radioresistance Fades G U E S T E D I TOR ’ S M E M O (continued on page 80) Bernard J. Escudier, MD I
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