418 research outputs found
Prognostication for surgically treated papillary renal cell carcinoma: which model is the optimal choice?
No full textSurgically treated papillary renal cell carcinoma shows distinct prognosis and needs specific prognostic models for counseling, follow-up and high-risk patient identification. Our goal is to summarize and compare currently recommended models
What Is the Real Impact of Concomitant Antibiotics or Proton Pump Inhibitors on Efficacy of Atezolizumab-Based Regimens in Patients With NSCLC?
No full text
Comparing a Part with the Whole: Beware of the Disparity of the Renal Cell Carcinoma Prognostic Models
No full textComparing the prognostic models to predict oncologic outcomes in patients with renal cell carcinoma: is AUC close enough to clinical practice?
No full textExploring genetic and immune underpinnings of the sexual dimorphism in tumor response to immune checkpoints inhibitors: A narrative review
No full textINTRODUCTION: In spite of the undisputed relevance of sex as critical biologic variable of the immune landscape, still limited is our understanding of the basic mechanisms implicated in sex-biased immune response thereby conditioning the therapeutic outcome in cancer patients. This hindrance delays the actual attempts to decipher the heterogeneity of cancer and its immune surveillance, further digressing the achievement of predictive biomarkers in the current immunotherapy-driven scenario. Body: The present review concisely reports on genetic, chromosomal, hormonal, and immune features underlying sex-differences in the response to immune checkpoint inhibitors (ICIs). In addition to outline the need of robust data on ICI pharmaco-kinetics/dynamics, our survey might provide new insights on sex determinants of ICI efficacy and suggests uncovered pathways that warrant prospective investigations. CONCLUSION: According to a sharable view, we propose to widely include sex among the co-variates when assessing the clinical response to ICI in cancer patients
External validation of the GRade, Age, Nodes and Tumor (GRANT) score for patients with surgically treated papillary renal cell carcinoma. - Proceedings from the Second International Urology Cancer Summit, 27th September, Portsmouth, UK.
No full textObjective: Stratifying the risk of recurrence for surgically treated papillary renal cell carcinoma (pRCC) could be challenging. Prognostic models are crucial for patient counselling, individualized surveillance, and identifying potential candidates for adjuvant therapy. The GRANT score is one of the models suggested by European Association Urology (EAU) guidelines to predict prognosis of surgically treated pRCC. This study aims to externally validate the GRANT score using a three-risk group stratification in a large cohort of pRCC patients.
Methods: The present analysis utilized retrospective data from pRCC patients who underwent radical or partial nephrectomy, as collected by Wagener et al. [PMID: 28934212]. The GRANT score parameters included tumor grade, age, pathological T-stage, and N-stage. Patients were stratified into three risk groups (0-1 vs. 2 vs. 3-4 risk factors). Cancer-specific survival (CSS) was assessed using the Kaplan-Meier method, and differences between groups were evaluated using the log-rank test. Harrell’s c-index was used to measure model accuracy, and restricted mean survival time (RMST) was calculated for up to 120 months.
Results: A total of 1,942 patients were analysed. The median follow-up was 64.6 months. Patients aged > 60 years comprised 58% of the population, and 75.6% were male. At 60 months, CSS was 93.2% (95%CI 91.7%-94.6%) for group 1, 60.8% (95%CI 54.0%-78.6%) for group 2, and 26% (95%CI 15.7%-42.9%) for group 3, with significant differences between each group (p < 0.001). The median CSS was not reached for group 1 (95%CI NR-NR), 86.0 months in group 2 (95%CI 65-NR), and 22.8 months in group 3 (95%CI 16.4-48.0), Figure 1. The c-index for CSS was 0.732. The RMST at 120 months was 113.3 months for group 1, 75.9 months for group 2, and 56.6 months for group 3, resulting in a statistically significant difference (p < 0.001).
Conclusions: The GRANT score effectively stratified surgically treated pRCC patients into three risk groups with significant differences in CSS, demonstrating good prognostic accuracy. This validation supports the GRANT score’s utility as a reliable and easy-to-use tool for predicting prognosis in surgically treated pRCC patients
Systemic adjuvant therapies in renal cell carcinoma
No full textRenal cell carcinoma (RCC) is one of the ten most frequent solid tumors worldwide. Recent innovations in the treatment of metastatic disease have led to new therapeutic approaches being investigated in the adjuvant setting. Observation is the only current standard of care after radical nephrectomy, although there is evidence of efficacy of adjuvant use of vaccine among all the strategies used. This article aims to collect published experiences with systemic adjuvant approaches in RCC and to describe the results of past and ongoing phase III clinical trials in this field. We explored all the systemic treatments, including chemotherapy, immunotherapy and targeted drugs while alternative approaches have also been described. Appropriate selection of patients who would benefit from adjuvant therapies remains a crucial dilemma. Although the international guidelines do not actually recommend any adjuvant treatment after radical surgery for RCC, no conclusions have yet been drawn pending the results of the promising ongoing clinical trials with the target therapies. The significant changes that these new drugs have made on advanced disease outcome could represent the key to innovation in terms of preventing recurrence, delaying relapse and prolonging survival after radical surgery for RCC
- …
