NOV EMBER /DECEMBER 2021
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VOLUME 20, IS SUE NUMBER 6
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www.renalandurologynews.com
RT for Oligometastatic RCC Promising
© IMAGE COURTESY OF CHAD TANG, MD
Serial radiation therapy could provide an alternative to standard-of-care systemic therapy
LUNG METASTASIS in oligometastatic RCC before (left) and after SBRT.
ICPi-AKI Predictors Identified BY JODY A. CHARNOW LOWER BASELINE kidney function, use of proton pump inhibitors (PPIs), and extrarenal immune-related adverse events are independent risk factors for acute kidney injury related to immune checkpoint inhibitors (ICPi-AKI), according to study data presented at the American Society of Nephrology’s Kidney Week 2021. The study included 429 patients diagnosed with ICPi-AKI at 30 sites across North America, Europe, and Asia. ICI-related AKI developed at a median of 16 weeks after ICPi initiation. Investigators compared these patients with 429 controls who received ICPi therapy contemporaneously but did not experience ICPi-AKI.
Compared with a baseline estimated glomerular filtration rate (eGFR, in mL/ min/1.73 m2) of 90 or higher, values of 45-59 and less than 45 were significantly associated with 2.2- and 2.6-fold increased odds of ICPi-AKI, respectively, in adjusted analyses, first author Shruti Gupta, MD, MPH, of Brigham and Women’s Hospital in Boston, Massachusetts, reported. PPI use was significantly associated with 2.4-fold increased odds of ICI-related AKI compared with nonuse. Prior or concomitant extrarenal immune-related adverse events were significantly associated with 2.1-fold increased odds of ICPi-AKI. Renal recovery, defined as a nadir serum creatinine level less than or equal continued on page 6
BY JOHN SCHIESZER SERIAL RADIATION therapy appears to be safe and effective as an alternative treatment to systemic therapy for oligometastatic renal cell carcinoma (RCC), recent study findings suggest. The findings challenge a widely held belief in radiation oncology that RCC is biologically radioresistant, said lead investigator Chad Tang, MD, an assistant professor of radiation oncology at The University of Texas MD Anderson Cancer Center, Houston, Texas. Radiation has mostly been used as a palliative approach to relieve pain or manage symptoms in patients with metastatic RCC. Trial results, which were published in The Lancet Oncology, show that serial
DFS Predicts OS After First Nephrectomy LONGER DISEASE-FREE survival (DFS) following initial nephrectomy for intermediate-high risk and high-risk renal cell carcinoma (RCC) predicts longer overall survival (OS), investigators reported at the International Kidney Cancer Symposium (IKCS) 2021. The finding suggests that DFS can be useful as a predictor of OS in the RCC adjuvant setting when the OS data are immature, they concluded. The investigators, Naomi B. Haas, MD, of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues, stated that as far as they are aware, their study is the first to assess the association between DFS and OS among patients with intermediate-high risk and highrisk RCC post-nephrectomy using realworld patient-level data. Dr Haas’ team conducted a retrospective observational study using 20072016 data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare continued on page 6
radiation therapy offered progressionfree survival (PFS) similar to frontline systemic therapy, but with much less toxicity, Dr Tang said. The trial also provided evidence of the biologic effectiveness of radiotherapy at the histologic level in paired biopsy samples. Dr Tang and colleagues analyzed the use of stereotactic body radiation therapy (SBRT) as an alternative treatment to standard-of-care systemic therapy for oligometastatic RCC. The researchers enrolled 30 patients between July 2018 and September 2020 who were diagnosed with clear cell RCC and had 5 or fewer metastatic lesions. The trial consisted of 20 Whites (67%), 7 Hispanics (23%), 2 Blacks (7%), and 1 Native continued on page 6
IN THIS ISSUE 4
Prostate cancer found to lower kidney transplant odds
5
Video shows promise in informing men about PCa genetic testing
12
Reasons why men drop PCa active surveillance identified
12
Air pollution may worsen kidney transplant outcomes
13
Partial, radical cystectomy for MIBC may offer similar survival
15
Chest imaging after surgery for RCC T1a tumors not warranted
15
Few patients stay on PTNS therapy for OAB long term
Long-term aspirin use is associated with a lower risk for CKD progression. PAGE 3
