T A B L E O F C O N T E N T S
ASCO 2019 Postscript: Inflection Point?
Pivotal Results? Hold On, Not So Fast
ith more than 2,400 abstracts accepted for presentation
at the 2019 ASCO Annual Meeting, and
more than 3,200 additional abstracts accepted for
online publication, this year’s scientific sessions offered
clinicians an incredible selection of information from
which to glean insights and consider potentially practice
changing data. As always, it is tempting to review selected
abstracts in renal cell carcinoma (RCC) and speculate to
what extent the emerging results presented in kidney cancer
could suggest an inflection point for treatment and
whether some of the exciting abstracts could have significant impact on
our management strategies.
Targeted Therapy Era Immunotherapy Combination Era
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
In contrast to previous ASCO meetings, the consensus seemed to be
that the 2019 sessions did not eclipse the pivotal information we have seen
emerging from earlier symposia where one could sense that the “needle”
was moving perceptibly on various issues. For example, compared to previous
years, none of the information at this year’s ASCO was selected for
review during the Plenary sessions, a bellwether that suggests significant
potential impact on clinical practice. Despite the absence of kidney cancer
in the Plenary sessions, many abstracts in RCC merit attention and some
of these are covered elsewhere in this issue of the Kidney Cancer Journal.
In commentaries, blogs, and interviews featuring ASCO-related analyses
with key opinion leaders, these trends were among those attracting wide
attention:
• Results demonstrated the safety and benefit of immune checkpoint
Editorial Mission
The purpose of Kidney Cancer Journal is to serve as a compre-
hensive 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
Los Angeles, California
Medical Advisory Board
Michael B. Atkins, MD
Deputy Director
Lombardi Comprehensive Cancer Center
Professor of Oncology and Medicine,
Georgetown University Medical Center
Washington, DC
Robert J. Motzer, MD
Attending Physician
Memorial Sloan-Kettering
Cancer Center
New York, NY
Brian Rini, MD
Professor of Medicine
Cleveland Clinic Lerner College of
Medicine of Case Western
Reserve University
Cleveland, Ohio
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
Gretchen Vaughan
Chief Executive Officer
Kidney Cancer Association
Publishing Staff
Stu Chapman, Executive Editor
Jenny Chapman, Director, Business Development
Michael McClain, Design Director
Director of Advertising
Susan Hirschhaut
(847) 476-0588
susan@datamedica.org
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About the Cover
Answers to quiz on which drugs are represented by molecules:
(A) Pembrolizumab (Keytruda), (B) Sunitinib (Sutent), (C) Lenvatinib
(Lenvima), (D) Nivolumab (Opdivo). Larger image depicts a
66-year-old male with metastatic renal carcinoma. Fused Whole
Body FDG PET CT Scan following intravenous administration of
9.7 mCi of 18-FDG reveals metabolically active tumor in right
paratracheal lymph node chain and confluent adenopathy in
the mid-abdomen, retroperitoneum in aortocaval chain.
32 Journal Club
33 Medical Intelligence
34 Interview with Gretchen Vaughan, new CEO of Kidney Cancer
Association
36 Original Contribution: Patients Perspectives on Adjuvant Therapy
in Renal Cell Carcinoma
41 Optimizing Prognostication in mRCC: Recent Advances and
New Directions
48 Brain Metastases in RCC: New Trials, Novel Treatment Approaches
53 Special Report: Highlights from ASCO 2019
G U E S T E D I TO R ’ S M E M O
(continued on page 40)
Sumanta (Monty) Pal, MD
W
Treatment Landscape for Metastatic RCC
Sorafenib
Sunitinib
Temsirolimus Axitinib Nivolumab +
Ipilimumab
Bevacizumab + IFNα
Everolimus
Pazopanib
Nivolumab
Cabozantinib
Everolimus + Lenvatinib
Pembrolizumab
+ Axitinib
Avelumab +
Axitinib
link