T A B L E O F C O N T E N T S
A Retrospective Look at Progress to Date
and New Directions in 2020 and Beyond
f we could locate points on a compass serving as a metaphor
for future directions in kidney cancer management,
the directions most likely would turn toward combination
therapies, biomarkers, precision medicine, and innovative
treatment approaches. There are numerous points in between
arising from the unmet need to explore a myriad of different
directions—all of which provided touchstones for discussion
at the recently held 18th International Kidney Cancer Symposium
in Miami, November 15-16, attracting more than 400
attendees. This was one of the largest crowds to attend the
IKCS, sponsored by the Kidney Cancer Association. Two international
symposia are held each year, the second scheduled for Antwerp,
Belgium in 2020.
I had the pleasure and honor to serve as one of 80 speakers at the scientific
sessions as key opinion leaders and investigators presented, analyzed, debated,
and looked toward some consensus on numerous issues in a program ranging
across the broadest possible spectrum of topics on renal cell carcinoma offered
at any meeting worldwide. And yet, as broad as that spectrum was, there are a
handful of overarching concerns that still dominate the narrative—among
them the four mentioned at the beginning of my message.
During the last year, for example, two major approvals of combination therapies
have provided compelling evidence for changing the paradigm of firstline
therapy. The FDA approval of axitinib and pembrolizumab and of axitinib
and avelumab expand our options to optimize combinatorial approaches, in
addition to the approval of ipilimumab and nivolumab in 2018 . And what
about the other “points on the compass” identified earlier? Verification of biomarkers
to help guide these choices remains arguably the most elusive goal
and a formidable challenge we face. Innovative and novel approaches are
emerging as more of the tumor microenvironment is revealed.
Successful prognostication of patients is critical to both the clinical practice
of oncology and research, as it influences treatment approaches and may be
used to stratify patients in clinical trials. Classically, the most robust prognostic
variables were related to histology (subtype, grade, tumor size), clinical features
(performance status and pace of disease), or laboratory parameters. As nomograms
utilizing these variables have come under closer scrutiny, we are seeing a
dramatic evolution in how these models can be improved with underlying genomic
information. The article in this issue of the Kidney Cancer Journal on precision
medicine offers a striking perspective on how BAP1 and PBRM1
expression, for example, can potentially enhance these prognostic models. Yes,
we are making progress on extending the frontier of biomarker applications
but the limitations are still formidable to achieve truly personalized medicine.
Editorial Mission
The purpose of Kidney Cancer Journal is to serve as a com-
prehensive 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 trans-
lational 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
Chief of Clinical Trials
Vanderbilt-Ingram Cancer Center
Vanderbilt University Medical Center
Nashville, Tennessee
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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Copyright © 2019 Genitourinary Publishing. All rights reserved.
None of the contents may be reproduced in any form without
the permission of the publisher.
About the Cover
Image depicts how modeling studies in mice, indicating mutational
factors that drive tumor development, including BPRM1
and BAP1, result in different pathological outcomes, including
risk of death. (See article on page 94).
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@ KidneyCancerJ
92 Journal Club
93 Medical Intelligence
94 Next Generation Sequencing in Renal Cell Carcinoma:
Towards Precision Medicine
105 Revisiting IL-2 Therapy in Renal Cell Carcinoma:
A Case Repor t of a Patient Treated With Pegylated IL-2,
Bempegaldesleukin (NKTR-214)
108 Sur vival Outcome of Pazopanib and Sunitinib as First-line Targeted
Therapy in Metastatic RCC: ‘Real World’ Retrospective Review
G U E S T E D I TO R ’S M E M O
(continued on page 114)
I
Ulka Vaishampayan,
MD
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