Algemene opmerkingen en begrippenlijst
Algemene opmerkingen
- Alle patiënten met gemetastaseerd heldercellig niercelcarcinoom met IMDC intermediair of hoog risico dienen multidisciplinair besproken te worden in het nierkanker netwerk.
- Alle patiënten met gemetastaseerd niercelcarcinoom en een niet-heldercellige histologische variant dienen eveneens multidisciplinair besproken te worden in het nierkanker netwerk.
Begrippenlijst
- Heldercellig niercelcarcinoom (ccRCC)
- Renal cell carcinoma (RCC)
- IMDC (International Metastatic Renal Cell Carinoma) criteria zijn van belang voor het maken van een therapiekeuze.
IMDC criteria
-
- Karnofsky < 80% = WHO 2-4
- Hemoglobine < LLN
- Calcium > ULN
- Tijd tussen initiële diagnose en vaststellen metastasen < 1 jaar
- Neutrofiele granulocyten > ULN
- Trombocyten > ULN
0 risicofactoren = good risk
1-2 risicofactoren = intermediate risk
>2 risicofactoren = poor risk
- No evidence of disease (NED)
- Tyrosine kinase remmer (TKI)
- Immunotherapie – tyrosine kinase remmer (IO-TKI)
Tumorsoorten
Behandelschema's
Literatuur
- Choueiri et al, Cabozantinib versus everolimus in advanced renal cell carcinoma (METEOR): final results from a randomized, open-label, phase 3 trial. Lancet Oncology, 2016, 17: 917-27
- Choueiri et al, Nivolumab plus cabozantinib versus sunitinib for advanced renal-cell carcinoma, New England Journal of Medicine. 2021, 384: 829-41
- Choueiri et al, Lenvatinib plus pembrolizumab versus sunitinib as first-line treatment of patients with advanced renal cell carcinoma. (CLEAR)
- Choueiri et al, Overall survival with adjuvant pembrolizumab in renal-cell carcinoma, New England Journal of Medicine, 2024, 390 (15): 1359-71
- Escudier et al, Randomized, controlled, double-blind, cross-over trial assessing treatment preferences for pazopanib versus sunitinib in patients with metastastic renal cell carcinoma: PISCES Study, Journal of Clinical Oncology. 2014, 32 (14):1412-18
- Heng et al, External validation and comparison with other models of the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model: a population-based study. Lancet Oncology 2013, 14 (2): 141-148
- Motzer et al, Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. New England Journal of Medicine. 2007, 356 (2): 115-24
- Motzer et al, Efficacy of everolimus in advanced renal cell carcinoma: a double-blind, randomized, placebo-controlled phase III trial. Lancet. 2008, 372: 449-56
- Motzer et al, Pazopanib versus sunitinib in metastatic renal-cell carcinoma. New England Journal of Medicine, 2013, 369: 772-31
- .Motzer et al, Nivolumab versus everolimus in advanced renal-cell carcinoma, New England Journal of Medicine. 2015, 373 (19): 1803-1913
- Motzer et al, Nivolumab plus ipilimumab versus sunitinib in advance renal-cell carcinoma. New England Journal of Medicine. 2018, 378 (14): 1277-90
- Motzer et al, Lenvatinib plus pembrolizumab or everolimus for advanced renal cell carcinoma. New England Journal of Medicine, 2021, 384 (14): 1289-300
- Rini et al, Pembrolizumab plus axitinib versus sunitinib for advanced renal-cell carcinoma. New England Journal of Medicine 2019, 380: 1116-27
- Yip et al, Outcomes of metastatic Chromophobe Renal Cell Carcinoma (chRCC) in the targeted therapy era: results from the international metastatic renal cell cancer database consortium (IMDC). Kidney Cancer, 2021: 41-47