Keypoints:
• The role of Pembrolizumab in the adjuvant setting based on the Keynote 564 study and its implications for early-stage disease.
• Current treatment paradigms for metastatic RCC, including dual checkpoint inhibitors, TKI with immunotherapy, and single-agent options.
• The importance of patient characteristics and IMDC risk categorization in treatment decisions.
• Insights into sequencing therapies, including the use of Belzutifan for refractory disease and the management of side effects.
• The role of ctDNA, PD-L1 testing, and NGS in RCC.
In this episode of the Oncology Brothers podcast, we had the pleasure of welcoming Dr. Katy Beckermann, the Medical GU Director of Cancer Research at Tennessee Oncology, to discuss the evolving landscape of renal cell carcinoma (RCC).
We began by exploring the adjuvant treatment options for early-stage RCC, particularly focusing on the recent approval of Pembrolizumab based on the Keynote 564 study, which demonstrated both disease-free survival (DFS) and overall survival (OS) benefits. Dr. Beckermann emphasized the importance of personalizing treatment decisions based on the risk of recurrence and the patient's specific disease characteristics.
Transitioning to the metastatic setting, we discussed the various treatment options available, including dual checkpoint inhibitors, TKI with immunotherapy, and single-agent immunotherapy. Dr. Beckermann highlighted the significance of understanding the patient's disease burden and symptoms when selecting the appropriate frontline regimen, noting the role of IMDC categorization in prognostication.
We also delved into the sequencing of therapies for patients who progress after initial treatment, discussing the lack of definitive data in this area and the importance of switching mechanisms of action. Dr. Beckermann shared insights on newer agents like Balsutafan and their unique side effect profiles, particularly anemia and hypoxia, which require close monitoring.
Finally, we touched on the role of NGS in RCC, clarifying that while it can provide insights into disease aggressiveness, it currently lacks actionable mutations for treatment decisions.
Overall, this episode provided a comprehensive overview of the current treatment paradigms for RCC, emphasizing the need for personalized approaches and careful monitoring of side effects. We hope our listeners find this discussion valuable as they navigate the complexities of RCC treatment in their practice. Thank you for tuning in!
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