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Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline.

Publication ,  Journal Article
Rathmell, WK; Rumble, RB; Van Veldhuizen, PJ; Al-Ahmadie, H; Emamekhoo, H; Hauke, RJ; Louie, AV; Milowsky, MI; Molina, AM; Rose, TL; Siva, S ...
Published in: J Clin Oncol
September 1, 2022

PURPOSE: To provide recommendations for the management of patients with metastatic clear cell renal cell carcinoma (ccRCC). METHODS: An Expert Panel conducted a systematic literature review to obtain evidence to guide treatment recommendations. RESULTS: The panel considered peer-reviewed reports published in English. RECOMMENDATIONS: The diagnosis of metastatic ccRCC should be made using tissue biopsy of the primary tumor or a metastatic site with the inclusion of markers and/or stains to support the diagnosis. The International Metastatic RCC Database Consortium risk criteria should be used to inform treatment. Cytoreductive nephrectomy may be offered to select patients with kidney-in-place and favorable- or intermediate-risk disease. For those who have already had a nephrectomy, an initial period of active surveillance may be offered if they are asymptomatic with a low burden of disease. Patients with favorable-risk disease who need systemic therapy may be offered an immune checkpoint inhibitor (ICI) in combination with a vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor (TKI); patients with intermediate or poor risk should be offered a doublet regimen (no recommendation was provided between ICIs or an ICI in combination with a VEGFR TKI). For select patients, monotherapy with either an ICI or a VEGFR TKI may be offered on the basis of comorbidities. Interleukin-2 remains an option, although selection criteria could not be identified. Recommendations are also provided for second- and subsequent-line therapy as well as the treatment of bone metastases, brain metastases, or the presence of sarcomatoid features. Participation in clinical trials is highly encouraged for patients with metastatic ccRCC.Additional information is available at www.asco.org/genitourinary-cancer-guidelines.

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

September 1, 2022

Volume

40

Issue

25

Start / End Page

2957 / 2995

Location

United States

Related Subject Headings

  • Vascular Endothelial Growth Factor A
  • Protein Kinase Inhibitors
  • Oncology & Carcinogenesis
  • Kidney Neoplasms
  • Humans
  • Carcinoma, Renal Cell
  • Angiogenesis Inhibitors
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

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Rathmell, W. K., Rumble, R. B., Van Veldhuizen, P. J., Al-Ahmadie, H., Emamekhoo, H., Hauke, R. J., … Singer, E. A. (2022). Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline. J Clin Oncol, 40(25), 2957–2995. https://doi.org/10.1200/JCO.22.00868
Rathmell, W Kimryn, R Bryan Rumble, Peter J. Van Veldhuizen, Hikmat Al-Ahmadie, Hamid Emamekhoo, Ralph J. Hauke, Alexander V. Louie, et al. “Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline.J Clin Oncol 40, no. 25 (September 1, 2022): 2957–95. https://doi.org/10.1200/JCO.22.00868.
Rathmell WK, Rumble RB, Van Veldhuizen PJ, Al-Ahmadie H, Emamekhoo H, Hauke RJ, et al. Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline. J Clin Oncol. 2022 Sep 1;40(25):2957–95.
Rathmell, W. Kimryn, et al. “Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline.J Clin Oncol, vol. 40, no. 25, Sept. 2022, pp. 2957–95. Pubmed, doi:10.1200/JCO.22.00868.
Rathmell WK, Rumble RB, Van Veldhuizen PJ, Al-Ahmadie H, Emamekhoo H, Hauke RJ, Louie AV, Milowsky MI, Molina AM, Rose TL, Siva S, Zaorsky NG, Zhang T, Qamar R, Kungel TM, Lewis B, Singer EA. Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline. J Clin Oncol. 2022 Sep 1;40(25):2957–2995.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

September 1, 2022

Volume

40

Issue

25

Start / End Page

2957 / 2995

Location

United States

Related Subject Headings

  • Vascular Endothelial Growth Factor A
  • Protein Kinase Inhibitors
  • Oncology & Carcinogenesis
  • Kidney Neoplasms
  • Humans
  • Carcinoma, Renal Cell
  • Angiogenesis Inhibitors
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences