How Is Advanced Renal Cell Carcinoma Patient Care Managed?
How Is Advanced Renal Cell Carcinoma Patient Care Managed? from Patient Empowerment Network on Vimeo.
Dr. Moshe Ornstein from Cleveland Clinic delves into the management of advanced renal cell carcinoma, where the cancer has spread beyond the kidney. He highlights that while the majority of patients require therapy, a small subset may undergo observation with regular CT scans.
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Transcript:
Lisa Hatfield:
Another patient asking how is advanced renal cell carcinoma managed, and what is considered the standard of care for managing that?
Dr. Moshe Ornstein:
So when we talk about the management of advanced kidney cancer, when I hear advanced, I’m thinking about cancer that has spread beyond the kidney. So there are spots in the lungs, maybe there are spots in the liver or the bones, cancer that’s going to require therapy. I do want to highlight that there is a subset of patients in my practice, maybe 10 percent of patients who have advanced kidney cancer, and we’re actually just watching them with CT scans.
We actually don’t treat them, we just keep watching. That’s a minority. But it is important to know because if someone’s doctor tells them that we’re just going to watch it, it’s not necessarily a crazy thing. So to keep that in mind that there is a subset of patients, small percentage, but it’s a real percentage, where even though their kidney cancer is “metastatic,” it’s just going to be watched with careful CT scans, let’s say, every three to four months.
For the patient who is going to get treatment, which is the overwhelming number of patients, those patients are generally, when I say generally, I say in my practice, probably 95 percent of these patients are going to get an immunotherapy-based combination as their first line of treatment. Immunotherapy has different names in the literature. You might see immunotherapy, you might see checkpoint inhibitors. But what these are doing is they’re “releasing the brakes” on the body’s own immune system to attack the cancer. So the immunotherapy is either given in combination with another immunotherapy.
The only such combination we currently have is something called ipilimumab and nivolumab. And then some patients will get a combination of immunotherapy plus a targeted therapy. Targeted therapy is generally a therapy that inhibits the vasculature leading to the tumor. The way I describe it to patients is cutting off the blood supply to the tumor. So patients will either get, again, immunotherapy plus immunotherapy or an immunotherapy plus a targeted therapy. In this kind of short question-and-answer session, it’s hard to describe which patient gets what, but just as a broad overview, important to understand the big picture, so when patients and families are talking to the oncologist, to have an understanding of the general treatment paradigms.
