Metastatic Renal Cancer Medical Treatment

Size: px
Start display at page:

Download "Metastatic Renal Cancer Medical Treatment"

Transcription

1 Metastatic Renal Cancer Medical Treatment Bohuslav Melichar, M.D., Ph.D. Professor and Head Department of Oncology Palacký University Medical School and Teaching Hospital Olomouc, Czech Republic

2 Peculiarities of RCC Resistance to cytotoxic agents High VEGF production (fosters the growth of metastases) Unusul sites of metastatic disease (e.g. breast, pancreas, thyroid) Unpredictable course of disease (spontaneous regression or rapidly fatal disease) Paraneoplastic syndromes

3 pontaneous complete regression of RCC lung metastases after nephrectomy Melichar et al. Acta Oncol 2009, 48,

4 RCC metastases to the pancreas Čečka et al. Hepatogastroenterology 2009, 56,

5 Randomized trial of IFN+ VBL vs. VBL Pyrhonen et al. J Clin Oncol 1999, 17, 2859

6 Molecular pathology of RCC Brugarolas. N Engl J Med 2007, 356,

7 Expression of VEGF in different tumors Jubb et al. J Clin Pathol 2004, 57,

8 Actions of VEGF relevant for tumor growth Growth factor for endothelial cells (angiogenesis) Increased permeability (tumor hypertension, formation of malignant effusions) Inhibitory action on dendritic cells and lymphocytes (suppression of immune response) Growth factor of tumor cells

9 Patients progression-free (%) Time to progression in phase II trial of bevacizumab in RCC after cytokine failure Bevacizumab 10mg/kg q2w; p<0.001 Bevacizumab 3mg/kg q2w Placebo Months from date on-study Yang, et al. NEJM 2003;349:427 34

10 Probability of being progression-free Progression-free survival (investigator assessed) HR=0.63, p< Median progression-free survival: Bevacizumab + IFN = 10.2 months IFN + placebo = 5.4 months Number of patients at risk Time (months) IFN + placebo Bevacizumab + IFN Escudier et al. Lancet 2007, 370,

11 CALGB Rini et al. J Clin Oncol 26, 2008, 5422

12 Too many drugs for mrcc???

13 TKIs in RCC, 2010

14 Selectivity of kinase inhibitors Karaman et al. Nature Biotech 2008, 26,

15 Sunitinib in the first-line therapy of mrcc Motzer et al. N Engl J Med 2007, 356,

16 Overall survival after first-line sunitinib p = unstratified; p = stratified Motzer et al. J Clin Oncol 2009, 27, 3584

17 Pazopanib (GW786034) N(4)-(2,3-dimethyl-2H-indazol-6-yl)-N(4)-methyl-N(2)-(4-methyl- 3-sulphonamidophenyl)-2,4-pyrimidinediamine VEGFR-1 VEGFR-2 VEGFR-3 PDGF-aR PDGF-bR c-kit

18 Activity in mrcc in phase I trial Hurwitz HI et al. Clin Cancer Res 2009, 15, 4220

19 Randomized discontinuation trial of pazopanib Hutson TE et al. J Clin Oncol 2010, 28,

20 Response to pazopanib Hutson TE et al. J Clin Oncol 2010, 28,

21 VEG Sternberg et al. J Clin Oncol 28, 2010, 1061

22 Pazopanib in the therapy of mrcc Sternberg et al. J Clin Oncol 28, 2010, 1061

23 Subgroup analyses in VEG Sternberg et al. J Clin Oncol 28, 2010, 1061

24 Temsirolimus vs. interferon-alpha in patients with poor prognosis Hudes et al. N Engl J Med 2007, 356, 2271

25 Second-line therapy

26

27 PFS in patients treated with everolimus Motzer et al. Lancet 2008, 372, 449

28 Possible algorithm of targeted therapy of metastatic RCC Melichar B. Oncology (Basel) 2009, 77,

29

30

31 New agents Axitinib Tivozanib Cabozantinib Dovitinib

32 Axitinib vs. sorafenib in second line therapy Rini BI et al. Lancet 2011, 378,

33 Abstract No Axitinib for first-line metastatic RCC: Overall efficacy and pharmacokinetic analyses from a randomized phase II study BI Rini 1, V Grünwald 2, MN Fishman 3, B Melichar 4, T Ueda 5, PA Karlov 6, AH Bair 7, Y Chen 7, S Kim 7, E Jonasch 8 1 Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA; 2 Hannover Medical School, Hannover, Germany; 3 H. Lee Moffitt Cancer Center, Tampa, FL, USA; 4 University Hospital, Olomouc, Czech Republic; 5 Chiba Cancer Center, Urology, Chiba, Japan; 6 City Clinical Oncology Dispensary, Saint-Petersburg, Russia; 7 Pfizer Oncology, San Diego, CA, USA; 8 The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA

34 Study Design Lead-in period (Cycle 1) Axitinib 5 mg BID (4 wks) During Cycle 1 (subset of patients) Randomization criteria a BP 150/90 mmhg and 2 concurrent anti-htn medications and No grade 3 or 4 axitinib-related toxicities and No dose reduction Yes No R A N D O M I Z E 1:1 Arm A Axitinib 5 mg BID + Axitinib dose titration b (blinded therapy) Arm B Axitinib 5 mg BID + Placebo dose titration b (blinded therapy) ABPM c 6-h PK sampling d a For at least 2 consecutive weeks b Titrated stepwise to 7 mg BID and then to a maximum of 10 mg BID if criteria for randomization to dose titration were met Arm C Axitinib 5 mg BID (no dose titration) C Ambulatory blood pressure monitoring performed at baseline and on Cycle 1 Days 4 and 15 d 6-hr PK sampling performed on Cycle 1 Day 15 Rini et al. ASCO 2012

35 Clinical Efficacy of Axitinib for First-line Metastatic RCC Total a (N=213) Arm C Not eligible for dose titration (n=91) Arms A + B Eligible for dose titration (n=112) mpfs, mo (95% CI) b 14.5 (11.5, 17.4) 16.4 (11.0, 19.0) 14.5 (11.0, 19.3) ORR (95% CI) b 48% (41%, 55%) 59% (49%, 70%) 43% (34%, 53%) a Includes 10 patients who discontinued study treatment prior to decision for dose titration b As of April 30, 2012 CI = confidence interval; mpfs = median progression-free survival; ORR = objective response rate Rini et al. ASCO 2012

36 Clinical Outcome According to Diastolic Blood Pressure on Cycle 1 Day 15 Blood pressure parameter mpfs, mo ORR AUC 12, ng h/ml a DdBP DdBP dbp 10 mmhg, n= % <10 mmhg, n= % 15 mmhg, n= % <15 mmhg, n= % 90 mmhg, n= % <90 mmhg, n= % a Geometric mean dbp = diastolic blood pressure (per ambulatory blood pressure monitoring); DdBP = change in dbp from baseline; 36 mpfs = median progression-free survival; ORR = objective response rate Rini et al. ASCO 2012

37 How we choose the agent? 1. Efficacy 2. Tolerance 3. Potential for second-line treatments 4. Patient preference

38 The concept of targeted therapy

39 Side effects of therapy in AVOREN Escudier et al. Lancet 2007, 370,

40

41 Progression-free survival Melichar et al. Ann Oncol 2008, 19,

42 Side-effects of sunitinib Motzer RJ et al. JCO 2009, 27,

43 Side-effects of pazopanib Sternberg et al. J Clin Oncol 28, 2010, 1061

44 PISCES trial Escudier et al. ASCO 2012

45 Results of PISCES trial - efficacy Escudier et al. ASCO 2012

46 Results of PISCES trial patient preference Escudier et al. ASCO 2012

47 Case Study Male, born 1940 History of hypertension (since 1986) Nephrectomy for clear cell RCC in November 1997 Fall 2003 goiter detected Thyroidectomy performed in October 2003 Histology - clear cell RCC metastasis No evidence of other distant metastases

48 Case Study(continued) IFN-a (9 MU 3 times a week) administered between December 2003 and May 2005 Spring 2005 complained about diarrhea and obstipation, hiccups CT in May pancreatic tumor (60 mm, located in the tail) and lung metastases detected Cytology of the pancreatic tumor clear cell RCC metastasis

49 Case Study (continued) Entered into the phase II discontinuation trial of pazopanib (800 mg daily) in March 2006 Good tolerance (diarrhea gr. 1, epistaxis gr. 1, dermatitis gr. 1, hair discoloration) Stable disease on repeated CT scans Last control March, 2012, still on medication (800 mg daily), performance status (WHO) 0

50 Conclusions Need to utilize the potential of all drugs active in metastatic RCC Optimal algorithm still a matter of debate Comparable efficacy data for many agents Tolerance (spectrum of toxicity) and patients preference are important considerations Difficulties with drug access in Central and Eastern states of the EU

51 Management of metastatic RCC is a team endeavor

52 Thank you for your attention Olomouc, Moravia, Czech Republic

53 Presentation was financialy supported by GSK

Have Results of Recent Randomized Trials Changed the Role of mtor Inhibitors?

Have Results of Recent Randomized Trials Changed the Role of mtor Inhibitors? Have Results of Recent Randomized Trials Changed the Role of mtor Inhibitors? Bernard Escudier Institut Gustave Roussy Villejuif, France EIKCS Lyon April 2015 What is the current role of mtor inhibitors?

More information

David N. Robinson, MD

David N. Robinson, MD David N. Robinson, MD Background and Treatment of mrcc Background ~ 64,770 new cases of kidney/renal pelvis cancers will be diagnosed in the US in 2012 with an estimated 13,570 deaths [1] ~ 75% are clear-cell

More information

Negative Trials in RCC: Where Did We Go Wrong? Can We Do Better?

Negative Trials in RCC: Where Did We Go Wrong? Can We Do Better? Negative Trials in RCC: Where Did We Go Wrong? Can We Do Better? 9 th European Kidney Cancer Symposium, Dublin, April 2014 Tim Eisen Tim Eisen - Disclosures Company Research Support Advisory Board Trial

More information

Evidenze cliniche nel trattamento del RCC

Evidenze cliniche nel trattamento del RCC Criteri di scelta nel trattamento sistemico del carcinoma renale Evidenze cliniche nel trattamento del RCC Alessandro Morabito Unità Sperimentazioni Cliniche Istituto Nazionale Tumori di Napoli Napoli,

More information

Treatment Algorithm and Therapy Management in mrcc. Manuela Schmidinger Medical University of Vienna Austria

Treatment Algorithm and Therapy Management in mrcc. Manuela Schmidinger Medical University of Vienna Austria Treatment Algorithm and Therapy Management in mrcc Manuela Schmidinger Medical University of Vienna Austria A Paradigm Shift in the Treatment of mrcc 1. Sunitinib 2. Sorafenib 3. Bevacizumab+IFN-alpha

More information

Linee guida terapeutiche oncologiche. Francesco Massari U.O.C. di Oncologia Medica d.u. Azienda Ospedaliera Universitaria Integrata Verona

Linee guida terapeutiche oncologiche. Francesco Massari U.O.C. di Oncologia Medica d.u. Azienda Ospedaliera Universitaria Integrata Verona Linee guida terapeutiche oncologiche Francesco Massari U.O.C. di Oncologia Medica d.u. Azienda Ospedaliera Universitaria Integrata Verona 1 YOUNG SPECIALIST RENAL CARE Verona, 07-08 Marzo 2014 Clinical

More information

Immunotherapy versus targeted treatments in metastatic renal cell carcinoma: The return game?

Immunotherapy versus targeted treatments in metastatic renal cell carcinoma: The return game? Immunotherapy versus targeted treatments in metastatic renal cell carcinoma: The return game? Sylvie NEGRIER MD, PhD Centre Léon Bérard, Lyon Université Lyon I IMMUNOTHERAPY: A LONG AND WIDING ROAD! WHERE

More information

Timing of targeted therapy in patients with low volume mrcc. Eli Rosenbaum Davidoff Cancer Center Beilinson Hospital

Timing of targeted therapy in patients with low volume mrcc. Eli Rosenbaum Davidoff Cancer Center Beilinson Hospital 1 Timing of targeted therapy in patients with low volume mrcc Eli Rosenbaum Davidoff Cancer Center Beilinson Hospital 2 Wont be discussing: Symptomatic patients High volume disease Rapidly growing metastases

More information

Targeted Therapy in Advanced Renal Cell Carcinoma

Targeted Therapy in Advanced Renal Cell Carcinoma Targeted Therapy in Advanced Renal Cell Carcinoma Brian I. Rini, M.D. Department of Solid Tumor Oncology Glickman Urologic and Kidney Institute Cleveland Clinic Taussig Cancer Institute Cleveland, Ohio

More information

New strategies and future of target therapy in advanced kidney cancer

New strategies and future of target therapy in advanced kidney cancer New strategies and future of target therapy in advanced kidney cancer VHL Gene Inactivation VHL Complex Disrupted VHL Protein HIF1-a, HIF2-a Accumulation VEGF PDGF TGF-α, CXCR4 Angiogenesis Endothelial

More information

Sequencing of therapies in mrcc. Ari Hakimi MD Assistant Professor Urology Service, Department of Surgery MSKCC

Sequencing of therapies in mrcc. Ari Hakimi MD Assistant Professor Urology Service, Department of Surgery MSKCC Sequencing of therapies in mrcc Ari Hakimi MD Assistant Professor Urology Service, Department of Surgery MSKCC Old Paradigm Sequencing approved agents VEGF TKI Sunitinib Pazopanib Axitinib TKI TKI MTORi

More information

A Review in the Treatment Options for Renal Cell Cancer

A Review in the Treatment Options for Renal Cell Cancer A Review in the Treatment Options for Renal Cell Cancer Ali McBride, PharmD, MS BCPS, BCOP Clinical Coordinator Hematology/Oncology Department of Pharmacy The University of Arizona Cancer Center RENAL

More information

UPDATE FROM ASCO GU FEBRUARY 2018, SAN FRANCISCO, USA. Prof. David Pfister University Hospital of Cologne Germany RENAL CELL CARCINOMA

UPDATE FROM ASCO GU FEBRUARY 2018, SAN FRANCISCO, USA. Prof. David Pfister University Hospital of Cologne Germany RENAL CELL CARCINOMA UPDATE FROM ASCO GU FEBRUARY 2018, SAN FRANCISCO, USA Prof. David Pfister University Hospital of Cologne Germany RENAL CELL CARCINOMA DISCLAIMER Please note: The views expressed within this presentation

More information

Second - Line Debate: Axitinib

Second - Line Debate: Axitinib Second - Line Debate: Axitinib Alain Ravaud, MD PhD Bordeaux, France DISCLOSURES Member of Global, European and/or French advisory board in RCC and/or GU tumors for Pfizer, Novartis, GSK, Roche, BMS, Merck.

More information

Axitinib in renal cell carcinoma: now what do we do?

Axitinib in renal cell carcinoma: now what do we do? Renal Cell Carcinoma Axitinib in renal cell carcinoma: now what do we do? Ian D. Davis Monash University Eastern Health Clinical School, Level 2, Box Hill, Victoria 3128, Australia Correspondence to: Ian

More information

Inmunoterapia en cáncer renal metastásico: redefiniendo el tratamiento de segunda línea

Inmunoterapia en cáncer renal metastásico: redefiniendo el tratamiento de segunda línea Inmunoterapia en cáncer renal metastásico: redefiniendo el tratamiento de segunda línea Daniel Castellano Oncología Médica. Unidad de Tumores Genito-Urinarios Hospital Universitario 12 de Octubre I + 12

More information

The Therapeutic Landscape in Advanced Renal Cell Carcinoma

The Therapeutic Landscape in Advanced Renal Cell Carcinoma The Therapeutic Landscape in Advanced Renal Cell Carcinoma Cora Sternberg, MD, FACP Chairman, Department of Medical Oncology San Camillo-Forlanini Hospital Rome, Italy What best describes the change in

More information

Treatment of Renal Cell Carcinoma (RCC) in the Era of Targeted Agents

Treatment of Renal Cell Carcinoma (RCC) in the Era of Targeted Agents Conflict of Interest Treatment of Renal Cell Carcinoma (RCC) in the Era of Targeted Agents None Patrick Medina, PharmD, BCOP Associate Professor University of Oklahoma OKC, OK Learning Objectives Epidemiology

More information

Metastatic renal cancer (mrcc): Evidence-based treatment

Metastatic renal cancer (mrcc): Evidence-based treatment Metastatic renal cancer (mrcc): Evidence-based treatment José M. Ruiz Morales, M.D. Hospital Médica Sur April 18th, 2018 4th ESO-ESMO Latin American Masterclass in Clinical Oncology Disclosures Consulting:

More information

pan-canadian Oncology Drug Review Stakeholder Feedback on a pcodr Request for Advice Axitinib (Inlyta) for Metastatic Renal Cell Carcinoma

pan-canadian Oncology Drug Review Stakeholder Feedback on a pcodr Request for Advice Axitinib (Inlyta) for Metastatic Renal Cell Carcinoma pan-canadian Oncology Drug Review Stakeholder Feedback on a pcodr Request for Advice Axitinib (Inlyta) for Metastatic Renal Cell Carcinoma Pfizer Canada Inc. June 29, 2017 3 Stakeholder Feedback on a pcodr

More information

CLINICAL POLICY Department: Medical Management Document Name: Inlyta Reference Number: NH.PHAR.100 Effective Date: 05/12

CLINICAL POLICY Department: Medical Management Document Name: Inlyta Reference Number: NH.PHAR.100 Effective Date: 05/12 Page: 1 of 5 IMPORTANT REMINDER This Clinical Policy has been developed by appropriately experienced and licensed health care professionals based on a thorough review and consideration of generally accepted

More information

Medical Management of Renal Cell Carcinoma

Medical Management of Renal Cell Carcinoma Medical Management of Renal Cell Carcinoma Lin Mei, MD Hematology-Oncology Fellow Hematology, Oncology and Palliative Care Virginia Commonwealth University Educational Objectives Background of RCC (epidemiology,

More information

Sequential Therapy in Renal Cell Carcinoma*

Sequential Therapy in Renal Cell Carcinoma* Sequential Therapy in Renal Cell Carcinoma* Bernard Escudier, MD, Marine Gross Goupil, MD, Christophe Massard, MD, and Karim Fizazi, MD, PhD Because of the recent approval of several drugs for the treatment

More information

Dose individualization of sunitinib in mrcc: Toxicity-adjusted dose or Therapeutic drug monitoring

Dose individualization of sunitinib in mrcc: Toxicity-adjusted dose or Therapeutic drug monitoring Dose individualization of sunitinib in mrcc: Toxicity-adjusted dose or Therapeutic drug monitoring Alison Zhang 1, Peter Fox 1, Sally Coulter 4, Val Gebski 5, Bavanthi Balakrishnar 1, Christopher Liddle

More information

Therapeutic effects and associated adverse events of multikinase inhibitors in metastatic renal cell carcinoma: A meta-analysis

Therapeutic effects and associated adverse events of multikinase inhibitors in metastatic renal cell carcinoma: A meta-analysis EXPERIMENTAL AND THERAPEUTIC MEDICINE 9: 2275-2280, 2015 Therapeutic effects and associated adverse events of multikinase inhibitors in metastatic renal cell carcinoma: A meta-analysis QINXIANG TAN 1*,

More information

Winship Cancer Institute of Emory University Neoadjuvant Systemic Therapy in Metastatic Renal Cell Carcinoma Patients

Winship Cancer Institute of Emory University Neoadjuvant Systemic Therapy in Metastatic Renal Cell Carcinoma Patients Winship Cancer Institute of Emory University Neoadjuvant Systemic Therapy in Metastatic Renal Cell Carcinoma Patients Bradley Carthon, MD, PhD Assistant Professor, Genitourinary Medical Oncology Winship

More information

CANCER UROLOGY VOL. 12. P. S. Borisov 1, M. I. Shkol nik 2, R. V. Orlova 3, P. A. Karlov 1 DOI: /

CANCER UROLOGY VOL. 12. P. S. Borisov 1, M. I. Shkol nik 2, R. V. Orlova 3, P. A. Karlov 1 DOI: / CANCER UROLOGY 3 6 VOL. The use of targeted therapies and selection of the optimal treatment sequence in heterogeneous population of patients with metastatic kidney cancer. Results of retrospective study

More information

What can we expect from running phase III trials: will all of them alter the current treatment algorithm?

What can we expect from running phase III trials: will all of them alter the current treatment algorithm? What can we expect from running phase III trials: will all of them alter the current treatment algorithm? 8 th European International Kidney Cancer Symposium Budapest, May 2013 Martin Gore PhD FRCP Royal

More information

Kidney Cancer Session

Kidney Cancer Session New Frontiers in Urologic Oncology September 12 th, 2015 Kidney Cancer Session Moderator: Philippe E. Spiess, M.D. Invited Faculty Members: Wade J. Sexton, MD Jeremiah J. Morrissey, PhD Agenda for Session

More information

Why was HOPE 205 a Positive After Years of Negative Studies?

Why was HOPE 205 a Positive After Years of Negative Studies? Why was HOPE 205 a Positive After Years of Negative Studies? Prof. Dr. med. Viktor Grünwald Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation Why do we pursue combinations?

More information

Renal Cell Carcinoma

Renal Cell Carcinoma Renal Cell Carcinoma Sequencing in renal cancer: two options for the same problem (TKImTOR) Viktor Grünwald Clinic for Hematology, Hemostasis, Oncology and Stemcelltransplantation Prof. Viktor Grünwald

More information

Targeted and immunotherapy in RCC

Targeted and immunotherapy in RCC Targeted and immunotherapy in RCC Treatment options Surgery (radical VS partial nephrectomy) Thermal ablation therapy Surveillance Immunotherapy Molecular targeted therapy Molecular targeted therapy Targeted

More information

2015 Eugene P. Schonfeld Award

2015 Eugene P. Schonfeld Award 2015 Eugene P. Schonfeld Award Eugene P. Schonfeld 1943-1997 Schonfeld Award Past Winners 2006 - David Swanson 2007 - Michael Atkins 2009 - Ronald Bukowski 2010 - Nicholas Vogelzang 2011 - Robert Motzer

More information

Developping the next generation of studies in RCC

Developping the next generation of studies in RCC Developping the next generation of studies in RCC Bernard Escudier Institut Gustave Roussy Villejuif, France Disclosure Information Advisory/Consultancy Role Pfizer, Exelixis, Novartis, BMS, Bayer, Roche,

More information

Integrating novel therapy in advanced renal cell carcinoma

Integrating novel therapy in advanced renal cell carcinoma Integrating novel therapy in advanced renal cell carcinoma Tian Zhang, MD Assistant Professor of Medicine GU Oncology Duke Cancer Institute March 11, 2017 Disclosures Research Funding Janssen Pfizer Consultant

More information

Complete Remission is a Reachable Goal in mrcc L. Albiges Institut Gustave Roussy

Complete Remission is a Reachable Goal in mrcc L. Albiges Institut Gustave Roussy Complete Remission is a Reachable Goal in mrcc L. Albiges Institut Gustave Roussy Is complete remission an achievable goal in mrcc? Lessons from observation Lessons from immunotherapy Current status in

More information

Innovaciones en el tratamiento del ca ncer renal. Enrique Grande

Innovaciones en el tratamiento del ca ncer renal. Enrique Grande Innovaciones en el tratamiento del ca ncer renal Enrique Grande The enriched inflammatory environment of RCC Chen Z, et al. Nat Rev Cancer 2014 Available agents are expanding across the three eras of arcc

More information

When to Treat Beyond Progression with Systemic Therapies? Manuela Schmidinger Medical University of Vienna, Austria

When to Treat Beyond Progression with Systemic Therapies? Manuela Schmidinger Medical University of Vienna, Austria When to Treat Beyond Progression with Systemic Therapies? Manuela Schmidinger Medical University of Vienna, Austria Is Treatment Beyond Progression a Valid Strategy? 1) NO YES? Is Treatment Beyond Progression

More information

A Phase II Study of Atezolizumab With or Without Bevacizumab vs Sunitinib in Untreated Metastatic Renal Cell Carcinoma Patients

A Phase II Study of Atezolizumab With or Without Bevacizumab vs Sunitinib in Untreated Metastatic Renal Cell Carcinoma Patients A Phase II Study of With or Without Bevacizumab vs in Untreated Metastatic Renal Cell Carcinoma Patients David McDermott, 1 Michael Atkins, 2 Robert Motzer, 3 Brian Rini, 4 Bernard Escudier, 5 Lawrence

More information

La revolución de la inmunoterapia: dónde la posicionamos? Javier Puente, MD, PhD

La revolución de la inmunoterapia: dónde la posicionamos? Javier Puente, MD, PhD La revolución de la inmunoterapia: dónde la posicionamos? Javier Puente, MD, PhD Hospital Universitario Clinico San Carlos Medical Oncology Department Thoracic & Urological Cancer Unit Complutense University

More information

Cytoreductive Nephrectomy

Cytoreductive Nephrectomy Cytoreductive Nephrectomy Stephen H. Culp, M.D., Ph.D. Assistant Professor, Department of Urology Outline The Historics of CN The current status of CN The importance of patient selection Cytoreductive

More information

Renal Cell Carcinoma: Status of Medical and Surgical Therapy. Ronald M. Bukowski Emeritus Physician Cleveland Clinic Foundation

Renal Cell Carcinoma: Status of Medical and Surgical Therapy. Ronald M. Bukowski Emeritus Physician Cleveland Clinic Foundation Renal Cell Carcinoma: Status of Medical and Surgical Therapy Ronald M. Bukowski Emeritus Physician Cleveland Clinic Foundation Metastatic Renal Cell Carcinoma: Evolution of Current Therapeutic Approaches

More information

Management of High Risk Renal Cell Carcinoma

Management of High Risk Renal Cell Carcinoma Management of High Risk Renal Cell Carcinoma Peter E. Clark, MD Professor and Chair, Department of Urology Carolinas HealthCare System Chair, Urologic Oncology Levine Cancer Institute October 14, 2017

More information

ASCO 2011 Genitourinary Cancer

ASCO 2011 Genitourinary Cancer ASCO 2011 Genitourinary Cancer Expanding Options for Chronic Diseases? Walter Stadler, MD, FACP University of Chicago Disclosures (All Non-University &/or Financial Dealings with Potential, Real, or Perceived

More information

CLINICAL CHALLENGES IN METASTATIC RENAL CELL CARCINOMA: THE RIGHT THERAPY FOR THE RIGHT PATIENT

CLINICAL CHALLENGES IN METASTATIC RENAL CELL CARCINOMA: THE RIGHT THERAPY FOR THE RIGHT PATIENT Daniel Heng, MD, MPH, FRCPC @DrDanielHeng Chair GU Tumour Group, Tom Baker Cancer Centre Clinical Professor, University of Calgary CLINICAL CHALLENGES IN METASTATIC RENAL CELL CARCINOMA: THE RIGHT THERAPY

More information

Current experience in immunotherapy for metastatic renal cell carcinoma

Current experience in immunotherapy for metastatic renal cell carcinoma Current experience in immunotherapy for metastatic renal cell carcinoma Axel Bex, MD, PhD The Netherlands Cancer Institute FOIU, Tel Aviv, 3 July 2018 Financial and Other Disclosures Off-label use of drugs,

More information

Atezolizumab Adjuvant Study: Medical Oncologist Perspective. Sumanta K. Pal, MD City of Hope Comprehensive Cancer Center

Atezolizumab Adjuvant Study: Medical Oncologist Perspective. Sumanta K. Pal, MD City of Hope Comprehensive Cancer Center Atezolizumab Adjuvant Study: Medical Oncologist Perspective Sumanta K. Pal, MD City of Hope Comprehensive Cancer Center Trial overview Key issues Outline Challenges with neoadjuvant therapy Placebo control

More information

pan-canadian Oncology Drug Review Final Clinical Guidance Report Axitinib (Inlyta) for metastatic Renal Cell Carcinoma March 7, 2013

pan-canadian Oncology Drug Review Final Clinical Guidance Report Axitinib (Inlyta) for metastatic Renal Cell Carcinoma March 7, 2013 pan-canadian Oncology Drug Review Final Clinical Guidance Report Axitinib (Inlyta) for metastatic Renal Cell Carcinoma March 7, 2013 DISCLAIMER Not a Substitute for Professional Advice This report is primarily

More information

Renal Cell Carcinoma: Systemic Therapy Progress and Promise

Renal Cell Carcinoma: Systemic Therapy Progress and Promise Renal Cell Carcinoma: Systemic Therapy Progress and Promise Michael B. Atkins, M.D. Deputy Director, Lombardi Comprehensive Cancer Ctr Georgetown University Medical Center Everolimus Rini, Campbell, Escudier.

More information

Renal Cell Cancer. Clinical case study 1 & 2. Petri Bono MD PhD Helsinki University Hospital Helsinki, Finland

Renal Cell Cancer. Clinical case study 1 & 2. Petri Bono MD PhD Helsinki University Hospital Helsinki, Finland Renal Cell Cancer Clinical case study 1 & 2 Petri Bono MD PhD Helsinki University Hospital Helsinki, Finland 1 Case study 1 - RCC and Lung Metastases Case study 1: Patient History Male, 63 years old Mild

More information

Indication for- and timing of cytoreductive nephrectomy Kidney- and bladder cancer: Immunotherapy

Indication for- and timing of cytoreductive nephrectomy Kidney- and bladder cancer: Immunotherapy Indication for- and timing of cytoreductive nephrectomy Kidney- and bladder cancer: Immunotherapy Axel Bex, MD, PhD The Netherlands Cancer Institute Oslo, September 4, 2018 Financial and Other Disclosures

More information

Prognostic Factors: Does It Really Matter if New Drugs for Targeted Therapy Will Be Used?

Prognostic Factors: Does It Really Matter if New Drugs for Targeted Therapy Will Be Used? european urology supplements 8 (2009) 478 482 available at www.sciencedirect.com journal homepage: www.europeanurology.com Prognostic Factors: Does It Really Matter if New Drugs for Targeted Therapy Will

More information

Fifteenth International Kidney Cancer Symposium

Fifteenth International Kidney Cancer Symposium The following presentation should not be regarded as an endorsement of a particular product/drug/technique by the speaker. The presentation topics were assigned to the speakers by the scientific committee

More information

Renal Cell Cancer: Present and Future. Bernard Escudier, Gustave Roussy

Renal Cell Cancer: Present and Future. Bernard Escudier, Gustave Roussy Renal Cell Cancer: Present and Future Bernard Escudier, Gustave Roussy [HKIOF May 2017] Sponsored by Bristol- Myers Squibb OPDIVO Hong Kong prescribing information is available upon request Disclosures

More information

ADVISORY COMMITTEE BRIEFING MATERIALS: AVAILABLE FOR PUBLIC RELEASE

ADVISORY COMMITTEE BRIEFING MATERIALS: AVAILABLE FOR PUBLIC RELEASE Tivozanib Hydrochloride in Advanced Renal Cell Carcinoma ADVISORY COMMITTEE BRIEFING MATERIALS: AVAILABLE FOR PUBLIC RELEASE AVEO PHARMACEUTICALS, INC. 75 Sidney Street Cambridge, MA 02139 Tel: (617) 299-5000

More information

Sustained Response to Temsirolimus in Chromophobe variant of Metastatic Renal Cell Carcinoma

Sustained Response to Temsirolimus in Chromophobe variant of Metastatic Renal Cell Carcinoma JOURNAL OF CASE REPORTS 2015;5(1):280-284 Sustained Response to Temsirolimus in Chromophobe variant of Metastatic Renal Cell Carcinoma Chanchal Goswami, Aditi Mandal B. P. Poddar Hospital & Medical Research

More information

NEXT GENERATION DRUGS IN KIDNEY CANCER. Dr Aine O Reilly Karolinska Institutet Stockholm, Sweden

NEXT GENERATION DRUGS IN KIDNEY CANCER. Dr Aine O Reilly Karolinska Institutet Stockholm, Sweden NEXT GENERATION DRUGS IN KIDNEY CANCER Dr Aine O Reilly Karolinska Institutet Stockholm, Sweden KIDNEY CANCER SUBTYPES Papillary Type 1 and 2 Medullary Collecting duct Chromophobe Translocation Clear cell

More information

Angiogenesis and tumor growth

Angiogenesis and tumor growth Anti-angiogenic agents: where we are? Martin Reck Department of Thoracic Oncology Hospital Grosshansdorf Germany Angiogenesis and tumor growth Journal of experimental Medicine 1972; 133: 275-88 1 Angiogenesis

More information

The Current Champion: Angiogenesis inhibitors

The Current Champion: Angiogenesis inhibitors The Current Champion: Angiogenesis inhibitors Baek-Yeol RYOO University of Ulsan College of Medicine ASAN Medical Center Dept. of Oncology Seoul, Korea Survival probability Sorafenib: Overall Survival

More information

Management Guidelines and Targeted Therapies in Metastatic Non-Small Cell Lung Cancer: An Oncologist s Perspective

Management Guidelines and Targeted Therapies in Metastatic Non-Small Cell Lung Cancer: An Oncologist s Perspective Management Guidelines and Targeted Therapies in Metastatic Non-Small Cell Lung Cancer: An Oncologist s Perspective Julie R. Brahmer, M.D. Associate Professor of Oncology The Sidney Kimmel Comprehensive

More information

Sunitinib Treatment for Metastatic Renal Cell Carcinoma in Patients with Von Hippel-Lindau Disease

Sunitinib Treatment for Metastatic Renal Cell Carcinoma in Patients with Von Hippel-Lindau Disease pissn 1598-2998, eissn 2005-9256 Cancer Res Treat. 2013;45(4):349-353 Case Report http://dx.doi.org/10.4143/crt.2013.45.4.349 Open Access Sunitinib Treatment for Metastatic Renal Cell Carcinoma in Patients

More information

Current Status of Studies on Targeted Therapy for Renal Cell Carcinoma

Current Status of Studies on Targeted Therapy for Renal Cell Carcinoma 294 Chin J Clin Oncol (2008) 5: 294~298 DOI 10.1007/s11805-008-0294-x Current Status of Studies on Targeted Therapy for Renal Cell Carcinoma Shaoqi Wang 1 Shaoxiang Wang 2 Juan Wang 1 1 Department of Oncology,

More information

Feasibly of axitinib as first-line therapy for advanced or metastatic renal cell carcinoma: a single-institution experience in Japan

Feasibly of axitinib as first-line therapy for advanced or metastatic renal cell carcinoma: a single-institution experience in Japan Koie et al. BMC Urology (2015) 15:32 DOI 10.1186/s12894-015-0027-4 RESEARCH ARTICLE Open Access Feasibly of axitinib as first-line therapy for advanced or metastatic renal cell carcinoma: a single-institution

More information

Horizon Scanning Technology Briefing. Sutent (Sunitinib) for first-line and adjuvant treatment of renal cell carcinoma

Horizon Scanning Technology Briefing. Sutent (Sunitinib) for first-line and adjuvant treatment of renal cell carcinoma Horizon Scanning Technology Briefing National Horizon Scanning Centre Sutent (Sunitinib) for first-line and adjuvant treatment of renal cell carcinoma August 2006: Updated October 2006 This technology

More information

I Kid(ney) You Not: Updates on Renal Cell Carcinoma

I Kid(ney) You Not: Updates on Renal Cell Carcinoma Disclosures I Kid(ney) You Not: Updates on Renal Cell Carcinoma Nothing to disclose Renee McAlister, PharmD, BCOP Clinical Pharmacist, GU/Melanoma Vanderbilt Ingram Cancer Center September 29, 2018 Objectives

More information

Invented name/name: Avastin International non-proprietary name/common name: bevacizumab TYPE II VARIATION: EMEA/H/C/000582/II/0015

Invented name/name: Avastin International non-proprietary name/common name: bevacizumab TYPE II VARIATION: EMEA/H/C/000582/II/0015 Invented name/name: Avastin International non-proprietary name/common name: bevacizumab TYPE II VARIATION: EMEA/H/C/000582/II/0015 Extension of indication to include: Avastin in combination with interferon

More information

Antiangiogenic Agents in NSCLC Where are we? Which biomarkers? VEGF Is the Only Angiogenic Factor Present Throughout the Tumor Life Cycle

Antiangiogenic Agents in NSCLC Where are we? Which biomarkers? VEGF Is the Only Angiogenic Factor Present Throughout the Tumor Life Cycle Antiangiogenic Agents in NSCLC Where are we? Which biomarkers? Martin Reck Department e t of Thoracic c Oncology ogy Hospital Grosshansdorf Germany VEGF Is the Only Angiogenic Factor Present Throughout

More information

Medical treatment of metastatic renal cell carcinoma (mrcc) in the elderly ( 65y): Position of a SIOG Taskforce

Medical treatment of metastatic renal cell carcinoma (mrcc) in the elderly ( 65y): Position of a SIOG Taskforce Medical treatment of metastatic renal cell carcinoma (mrcc) in the elderly ( 65y): Position of a SIOG Taskforce Medical treatment of metastatic RCC in the elderly ( 65y): Members of the SIOG Taskforce

More information

A randomized phase 2 trial of CRLX101 in combination with bevacizumab in patients with metastatic renal cell carcinoma (mrcc) vs standard of care

A randomized phase 2 trial of CRLX101 in combination with bevacizumab in patients with metastatic renal cell carcinoma (mrcc) vs standard of care A randomized phase 2 trial of CRLX101 in combination with bevacizumab in patients with metastatic renal cell carcinoma (mrcc) vs standard of care Martin H. Voss 1, Thomas Hutson 2, Arif Hussain 3, Ulka

More information

Renal Cell Carcinoma Updated February 2016 by Dr. Safiya Karim (PGY 5 Medical Oncology Resident, University of Toronto)

Renal Cell Carcinoma Updated February 2016 by Dr. Safiya Karim (PGY 5 Medical Oncology Resident, University of Toronto) Renal Cell Carcinoma Updated February 2016 by Dr. Safiya Karim (PGY 5 Medical Oncology Resident, University of Toronto) Reviewed by Dr. Nimira Alimohamed (Staff Medical Oncologist, University of Calgary)

More information

Emerging Biomarkers of VEGF and mtor Inhibitors in 2015

Emerging Biomarkers of VEGF and mtor Inhibitors in 2015 Emerging Biomarkers of VEGF and mtor Inhibitors in 2015 Laurence Albiges Institut Gustave Roussy, France Fourteenth International Kidney Cancer Symposium Miami, Florida, USA November 6-7, 2015 www.kidneycancersymposium.com

More information

The Really Important Questions Current Immunotherapy Trials are Not Answering

The Really Important Questions Current Immunotherapy Trials are Not Answering The Really Important Questions Current Immunotherapy Trials are Not Answering David McDermott, MD Beth Israel Deaconess Medical Center Dana Farber/Harvard Cancer Center Harvard Medical School PD-1 Pathway

More information

Positioning Antiangiogenesis Drugs and Other Agents in Renal Cell Cancer Treatment

Positioning Antiangiogenesis Drugs and Other Agents in Renal Cell Cancer Treatment Positioning Antiangiogenesis Drugs and Other Agents in Renal Cell Cancer Treatment Ahmad Awada, MD, PhD Medical Oncology Clinic Institut Jules Bordet Université Libre de Bruxelles (U.L.B.) Brussels, Belgium

More information

Tratamiento adyuvante y neoadyuvante del cáncer renal en Xavier Garcia del Muro Solans Institut Català d Oncologia Hospitalet.

Tratamiento adyuvante y neoadyuvante del cáncer renal en Xavier Garcia del Muro Solans Institut Català d Oncologia Hospitalet. Tratamiento adyuvante y neoadyuvante del cáncer renal en 2017 Xavier Garcia del Muro Solans Institut Català d Oncologia Hospitalet. Barcelona Pronóstico del CR mediante un sistema integrado en 468 pts

More information

A Phase II Study of Atezolizumab With or Without Bevacizumab vs Sunitinib in Untreated Metastatic Renal Cell Carcinoma Patients

A Phase II Study of Atezolizumab With or Without Bevacizumab vs Sunitinib in Untreated Metastatic Renal Cell Carcinoma Patients A Phase II Study of Atezolizumab With or Without Bevacizumab vs Sunitinib in Untreated Metastatic Renal Cell Carcinoma Patients Viktor Grünwald, 1 David McDermott, 2 Michael Atkins, 3 Robert Motzer, 4

More information

Reference No: Author(s) Approval date: June Committee. Operational Date: July Review:

Reference No: Author(s) Approval date: June Committee. Operational Date: July Review: Reference No: Title: Author(s) Systemic anti-cancer therapy (SACT) guidelines for renal cell cancer Dr Alison Clayton Consultant Medical Oncologist & Dr Jane Hurwitz Consultant Medical Oncologist, Cancer

More information

Alternativas de Futuro en Cáncer Renal Enrique Grande

Alternativas de Futuro en Cáncer Renal Enrique Grande Alternativas de Futuro en Cáncer Renal Enrique Grande Hospital Ramón y Cajal de Madrid The ncreasingly Challenging Field of mrcc Sorafenib (US 2005, EU 2006) 3,4 Sunitinib (US & EU 2006) 3,4 Early 1940s:

More information

Metastatic Renal Cell Cancer - Therapeutic Challanges 2011

Metastatic Renal Cell Cancer - Therapeutic Challanges 2011 Metastatic Renal Cell Cancer - Therapeutic Challanges 2011 Brian I. Rini, M.D. Department of Solid Tumor Oncology Cleveland Clinic Taussig Cancer Institute Glickman Urologic and Kidney Institute Cleveland,

More information

european urology 53 (2008)

european urology 53 (2008) european urology 53 (2008) 376 381 available at www.sciencedirect.com journal homepage: www.europeanurology.com Kidney Cancer High Frequency of Intracerebral Hemorrhage in Metastatic Renal Carcinoma Patients

More information

2 nd line Therapy and Beyond NSCLC. Alan Sandler, M.D. Oregon Health & Science University

2 nd line Therapy and Beyond NSCLC. Alan Sandler, M.D. Oregon Health & Science University 2 nd line Therapy and Beyond NSCLC Alan Sandler, M.D. Oregon Health & Science University Treatment options for advanced or metastatic (stage IIIb/IV) NSCLC Suitable for chemotherapy Diagnosis Unsuitable/unwilling

More information

When tyrosine kinase inhibitor sunitinib can be discontinued in metastatic renal cell carcinoma to pancreas: a case report

When tyrosine kinase inhibitor sunitinib can be discontinued in metastatic renal cell carcinoma to pancreas: a case report Sbitti et al. Journal of Medical Case Reports (2018) 12:80 https://doi.org/10.1186/s13256-018-1597-z CASE REPORT When tyrosine kinase inhibitor sunitinib can be discontinued in metastatic renal cell carcinoma

More information

A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO)

A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) Guideline 3-8-4 Version 2 A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) The Use of Targeted Therapies in Patients with Inoperable Locally Advanced or Metastatic

More information

Revisione Oral Abstracts

Revisione Oral Abstracts Revisione Oral Abstracts Francesco Massari Oncologia Medica Azienda Ospedaliero Universitaria di Bologna Policlinico S. Orsola-Malpighi UPDATES and NEWS from the Genitourinary Cancers Symposium - Milano,

More information

INTEGRATION OF SURGERY AND SYSTEMIC THERAPY FOR ADVANCED RENAL CELL CARCINOMA IN THE TARGETED THERAPY ERA

INTEGRATION OF SURGERY AND SYSTEMIC THERAPY FOR ADVANCED RENAL CELL CARCINOMA IN THE TARGETED THERAPY ERA INTEGRATION OF SURGERY AND SYSTEMIC THERAPY FOR ADVANCED RENAL CELL CARCINOMA IN THE TARGETED THERAPY ERA Dr. Michael J. Metcalfe PGY-4 Department of Urologic Sciences University of British Columbia October

More information

Checkpointinhibitoren in der Uro-Onkologie. Carsten Grüllich

Checkpointinhibitoren in der Uro-Onkologie. Carsten Grüllich Checkpointinhibitoren in der Uro-Onkologie Carsten Grüllich 07.02.15 T-cell Aktivierung und Regulation T cell Costimulation Recognition MHC I Peptide b2m mrna Tumorantigen Tumor Pardoll Nature Rev Cancer

More information

Sergio Bracarda MD. Head, Medical Oncology Department of Oncology AUSL-8 Istituto Toscano Tumori (ITT) San Donato Hospital Arezzo, Italy

Sergio Bracarda MD. Head, Medical Oncology Department of Oncology AUSL-8 Istituto Toscano Tumori (ITT) San Donato Hospital Arezzo, Italy Sergio Bracarda MD Head, Medical Oncology Department of Oncology AUSL-8 Istituto Toscano Tumori (ITT) San Donato Hospital Arezzo, Italy Ninth European International Kidney Cancer Symposium Dublin 25-26

More information

Prostate cancer Management of metastatic castration sensitive cancer

Prostate cancer Management of metastatic castration sensitive cancer 18 th Annual Advances in Oncology - 2017 Prostate cancer Management of metastatic castration sensitive cancer Urothelial carcinoma Non-muscle invasive urothelial carcinoma Updates in metastatic urothelial

More information

AVEO and Astellas Announce TAURUS Patient Preference Clinical Study Comparing Tivozanib with Sunitinib in First-Line Kidney Cancer

AVEO and Astellas Announce TAURUS Patient Preference Clinical Study Comparing Tivozanib with Sunitinib in First-Line Kidney Cancer FOR IMMEDIATE RELEASE AVEO and Astellas Announce TAURUS Patient Preference Clinical Study Comparing Tivozanib with Sunitinib in First-Line Kidney Cancer Study designed to build upon safety profile demonstrated

More information

Primary Care Management of the Kidney Cancer Patient

Primary Care Management of the Kidney Cancer Patient Primary Care Management of the Kidney Cancer Patient Elaine Lam, MD Mountain States Cancer Conference 2016 November 5, 2016 Learning Objectives 1. Understand the mechanisms of action of currently approved

More information

Targeted Therapies and Gut Microbiome in Renal Cell Carcinoma (RCC)

Targeted Therapies and Gut Microbiome in Renal Cell Carcinoma (RCC) Targeted Therapies and Gut Microbiome in Renal Cell Carcinoma (RCC) Nazli Dizman, MD Postdoctoral Fellow Department of Medical oncology & Experimental Therapeutics City of Hope Comprehensive Center December

More information

Prognostic Factors for mrcc: Relevance in Clinical Practice

Prognostic Factors for mrcc: Relevance in Clinical Practice Prognostic Factors for mrcc: Relevance in Clinical Practice Daniel Heng MD MPH FRCPC Chair, GU Tumor Group Tom Baker Cancer Center University of Calgary Prognostic Factors Patient Factors Performance Status

More information

ASCO 2012 Genitourinary tumors

ASCO 2012 Genitourinary tumors ASCO 2012 Genitourinary tumors Post ASCO Bern 14-06-2012 Dr. med. Richard Cathomas leitender Arzt Onkologie, KSGR, Chur Renal cell cancer Changes in first line treatment? Prostate cancer 3 positive phase

More information

pan-canadian Oncology Drug Review Final Clinical Guidance Report Nivolumab (Opdivo) for Metastatic Renal Cell Carcinoma September 1, 2016

pan-canadian Oncology Drug Review Final Clinical Guidance Report Nivolumab (Opdivo) for Metastatic Renal Cell Carcinoma September 1, 2016 pan-canadian Oncology Drug Review Final Clinical Guidance Report Nivolumab (Opdivo) for Metastatic Renal Cell Carcinoma September 1, 2016 DISCLAIMER Not a Substitute for Professional Advice This report

More information

Improving our understanding of papillary renal cell carcinoma with integrative genomic analysis

Improving our understanding of papillary renal cell carcinoma with integrative genomic analysis Perspective Page 1 of 5 Improving our understanding of papillary renal cell carcinoma with integrative genomic analysis Parth K. Modi 1, Eric A. Singer 1,2 1 Division of Urology, Rutgers Robert Wood Johnson

More information

Efficacy and safety of advanced renal cell carcinoma patients treated with sorafenib: roles of cytokine pretreatment

Efficacy and safety of advanced renal cell carcinoma patients treated with sorafenib: roles of cytokine pretreatment Efficacy and safety of advanced renal cell carcinoma patients treated with sorafenib: roles of cytokine pretreatment Hisanori Suzuki 1),2), Toshiro Suzuki 1),2), Osamu Ishizuka 1),2), Osamu Nishizawa 1),2),

More information

Angiogenesis Targeted Therapies in Renal Cell Carcinoma

Angiogenesis Targeted Therapies in Renal Cell Carcinoma Angiogenesis Targeted Therapies in Renal Cell Carcinoma John S. Lam, MD Department of Urology David Geffen School of Medicine University of California-Los Angeles Patient Case CC: Abdominal pain VS: T

More information

Click to edit Master /tle style. Cardiovascular Toxicity in Renal Cell Carcinoma Pa/ents

Click to edit Master /tle style. Cardiovascular Toxicity in Renal Cell Carcinoma Pa/ents Click to edit Master /tle style Cardiovascular Toxicity in Renal Cell Carcinoma Pa/ents Bernhard J. Eigl MD FRCPC Medical Oncologist, BC Cancer Agency Clinical Associate Professor, University of Bri/sh

More information

REAL WORLD PRACTICE: ADJUVANT THERAPY READY FOR PRIME TIME? PRO

REAL WORLD PRACTICE: ADJUVANT THERAPY READY FOR PRIME TIME? PRO REAL WORLD PRACTICE: ADJUVANT THERAPY READY FOR PRIME TIME? PRO Alain Ravaud, MD.PhD Bordeaux. France DISCLOSURES Consultant for: Pfizer, Novartis, GlaxoSmithKline, Roche, Bristol-Myers Squibb Institutional

More information

A) PUBLIC HEALTH EPIDEMIOLOGY

A) PUBLIC HEALTH EPIDEMIOLOGY A) PUBLIC HEALTH EPIDEMIOLOGY Incidence: 9th most common cancer worldwide, 11th most common in Canada, incidence 12.9/100,000 in Canada in 2015, highest incidence in developing countries, most common in

More information

Mechanisms and Management of Diarrhoea from Anti-VEGFR-TKIs. Manuela Schmidinger Medical University of Vienna Austria

Mechanisms and Management of Diarrhoea from Anti-VEGFR-TKIs. Manuela Schmidinger Medical University of Vienna Austria Mechanisms and Management of Diarrhoea from Anti-VEGFR-TKIs Manuela Schmidinger Medical University of Vienna Austria Clinical Presentation Frequency and severity varies between patients Intensity is dose-dependent

More information