Publications by authors named "Basappa N"
Background: Ipilimumab and nivolumab (ipi/nivo) improved overall survival (OS) compared to sunitinib in the pivotal Checkmate 214 trial of metastatic renal cell carcinoma (mRCC) with International Metastatic RCC Database Consortium (IMDC) intermediate/poor risk disease. We evaluated the efficacy and toxicity of ipi/nivo in older and frailer populations in a real-world mRCC cohort.
Methods: Analysis was conducted on a real-world cohort with mRCC (N = 551) treated with first-line ipi/nivo from the Canadian Kidney Cancer information system (CKCis) database from January 2014 to December 2021.
Background And Objective: Patients receiving immune checkpoint blockade (ICB) therapy may experience periods of prolonged disease control without a need for systemic therapy. Treatment-free survival (TFS) is an important measure for this period, but no data are available for patients with metastatic renal cell carcinoma (mRCC) starting first-line agents. Our aim was to analyze TFS outcomes for patients with mRCC starting first-line therapy.
View Article and Find Full Text PDFObjective: To evaluate and compare the outcomes of patients with localised renal cell carcinoma (RCC) with and without sarcomatoid features and the impact of this on cancer recurrence and survival.
Material And Methods: The Canadian Kidney Cancer information system database was used to identify patients diagnosed with localised RCC between January 2011 and December 2022. Patients with pT1-T3, n Nx-N0N1, M0 stage and documented sarcomatoid status were included.
Purpose: Postoperative prognostic tools allow for improved prediction of future recurrence risk, patient counseling, assessment of eligibility for adjuvant treatments, and appropriate follow-up surveillance. The purpose of this analysis was to validate prognostic models for patients with kidney cancer.
Materials And Methods: The Canadian Kidney Cancer information system is a prospective cohort of patients managed at 14 institutions since January 1, 2011, to present.
Introduction: Treatment intensification beyond androgen deprivation therapy (ADT) has shown survival benefit in patients with metastatic castration-sensitive prostate cancer (mCSPC). There is a need to better understand how these novel treatments fit in real-world practice.
Methods: Using electronic medical records and administrative data, a population-based, retrospective cohort study of patients diagnosed with de novo mCSPC between 2010 and 2020 in Alberta, Canada, and initiated on ADT was conducted.
Background: The management of advanced prostate cancer continues to evolve rapidly, particularly with the earlier use of survival-prolonging therapies in metastatic castration-sensitive prostate cancer (mCSPC). Though approved prior to the use of intensification therapy in mCSPC, taxane-based chemotherapies remain a relevant option for patients with metastatic castration-resistant prostate cancer (mCRPC). However, there is little evidence determining the outcomes of taxane chemotherapies as the first subsequent taxane (FST) in mCRPC pts who received docetaxel intensification (DI) in mCSPC.
View Article and Find Full Text PDFA patient with metastatic renal cell carcinoma on axitinib and pembrolizumab had elevated high-sensitivity cardiac troponin T and normal high-sensitivity cardiac troponin I with unremarkable cardiac investigations. A noncardiac cause (myositis) was the likely cause for cardiac troponin T elevation. Cardiac troponin I may be a more appropriate marker to support a myocarditis diagnosis with concurrent myositis.
View Article and Find Full Text PDFImmunotherapy-based systemic treatment (ST) is the standard of care for most patients diagnosed with metastatic renal cell carcinoma (mRCC). Cytoreductive nephrectomy (CN) has historically shown benefit for select patients with mRCC, but its role and timing are not well understood in the era of immunotherapy. The primary objective of this study is to assess outcomes in patients who received ST only, CN followed by ST (CN-ST), and ST followed by CN (ST-CN).
View Article and Find Full Text PDFBackground: Lymphocytes are closely linked to mechanisms of action of immuno-oncology (IO) agents. We aimed to assess the prognostic significance of absolute lymphocyte count (ALC) in patients with metastatic renal cell carcinoma (mRCC).
Patients And Methods: Using the International mRCC Database Consortium (IMDC), patients receiving first-line IO-based combination therapy were analysed.
Background: Current tobacco smoking is independently associated with decreased overall survival (OS) among patients with metastatic renal cell carcinoma (mRCC) treated with targeted monotherapy (VEGF-TKI). Herein, we assess the influence of smoking status on the outcomes of patients with mRCC treated with the current first-line standard of care of immune checkpoint inhibitor (ICI)-based regimens.
Materials And Methods: Real-world data from the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) were collected retrospectively.
In the phase 3 CLEAR trial, lenvatinib plus pembrolizumab (L + P) showed superior efficacy versus sunitinib in treatment-naïve patients with advanced renal cell carcinoma (aRCC). The combination treatment was associated with a robust objective response rate of 71%. Here we report tumor responses for patients in the L + P arm in CLEAR, with median follow-up of ∼4 yr at the final prespecified overall survival (OS) analysis.
View Article and Find Full Text PDFBackground: Cabozantinib, an oral multi-targeted tyrosine kinase inhibitor (TKI), has demonstrated efficacy in metastatic renal cell carcinoma (mRCC). The association between toxicity and therapeutic effectiveness has been established with other TKIs. We investigated whether cabozantinib dose reductions, a surrogate for toxicity and adequate drug exposure, were associated with improved clinical outcomes in mRCC.
View Article and Find Full Text PDFArticle Synopsis
- There's a meeting called the Canadian Consensus Forum (CCF3) where doctors talked about how to manage prostate cancer (PCa) better.
- They discussed important topics like treatment options and how to test for the disease using new technology.
- The doctors agreed on more than half of the questions discussed, helping to guide future treatment and research to improve care for patients with prostate cancer.
Patients with brain metastases (BrM) from renal cell carcinoma and their outcomes are not well characterized owing to frequent exclusion of this population from clinical trials. We analyzed data for patients with or without BrM using the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC). A total of 389/4799 patients (8.
View Article and Find Full Text PDFIntroduction: Lenvatinib plus pembrolizumab was found to have antitumor activity and acceptable safety in previously treated metastatic NSCLC. We evaluated first-line lenvatinib plus pembrolizumab versus placebo plus pembrolizumab in metastatic NSCLC in the LEAP-007 study (NCT03829332/NCT04676412).
Methods: Patients with previously untreated stage IV NSCLC with programmed cell death-ligand 1 tumor proportion score of at least 1% without targetable EGFR/ROS1/ALK aberrations were randomized 1:1 to lenvatinib 20 mg or placebo once daily; all patients received pembrolizumab 200 mg every 3 weeks for up to 35 cycles.
Article Synopsis
- Metastatic renal cell carcinoma (mRCC) patients treated with immunotherapies (IO) show better overall survival outcomes compared to those treated with targeted therapies (TT), particularly in those with or without sarcomatoid features.
- A study involving 1,202 patients assessed the impact of different first-line systemic therapies, revealing that IO treatment led to a significantly longer median survival than TT for both nonsarcomatoid (72 vs. 48 months) and sarcomatoid (48 vs. 18 months) patients.
- The study utilized real-world data from the IMDC database and applied statistical models to ensure balanced comparisons, ultimately highlighting the effectiveness of IO in metastatic RCC treatment.
Article Synopsis
- High-dose chemotherapy with autologous stem-cell transplantation (HDC-ASCT) is a standard treatment for patients with metastatic germ cell tumors (mGCTs) who relapse after conventional chemo, and this study reviews its effectiveness in Alberta, Canada, over 20 years.
- A review of 43 patients treated with HDC-ASCT revealed a median age of 28, with most having non-seminoma tumors; survival rates showed 42% were disease-free at last follow-up.
- The findings suggest that HDC-ASCT is an effective second-line therapy for mGCT, with indications that tandem transplants may yield better outcomes, though the results are limited by a small sample size.
Article Synopsis
- The study examines the integration and use of systemic therapies for metastatic renal cell carcinoma (mRCC) in Canada between 2011 and 2021, highlighting significant advancements in treatment options over the years.
- Data was collected from the Canadian Kidney Cancer Information System, involving 4,107 patients, with a focus on treatment trends and patient demographics across two separate time cohorts.
- The findings indicate a rise in the use of immune checkpoint inhibitors and a shift towards vascular endothelial growth factor-tyrosine kinase inhibitors as subsequent treatments, with about 18-24% of patients participating in clinical trials based on their treatment line.
Article Synopsis
- A study explored the impact of cytoreductive nephrectomy (CN) on outcomes for patients with metastatic renal cell carcinoma (mRCC) receiving immunotherapy, comparing those who had CN before or after treatment to those who did not undergo CN at all.
- The analysis included 385 patients and found that those who had CN before treatment exhibited better overall survival rates and were generally younger with fewer poor-risk factors compared to those who did not have surgery.
- Limitations of the study include its retrospective design and lack of randomization, but it suggests that CN remains a beneficial surgical option even in the era of new immunotherapeutic approaches.
Purpose: To compare characteristics and outcomes of patients included versus those not in adjuvant therapy trials post complete resection of renal cell carcinoma (RCC).
Methods: Adult patients following complete resection for clear cell RCC between January 1, 2011, and March 31, 2021, were included. Patients had intermediate high, high risk nonmetastatic disease (modified UCLA Integrated Staging System) or fully resected metastatic (M1) disease as per the inclusion criteria of adjuvant studies.
Introduction: Several recent randomized trials evaluated the impact of adjuvant immune checkpoint inhibitor (ICI)-based therapy on post-surgical outcomes in renal cell carcinoma (RCC), with disparate results. The objective of this consensus statement is to provide data-driven guidance regarding the use of ICIs after complete resection of clear-cell RCC in a Canadian context.
Methods: An expert panel of genitourinary medical oncologists, urologic oncologists, and radiation oncologists with expertise in RCC management was convened in a dedicated session during the 2022 Canadian Kidney Cancer Forum in Toronto, Canada.
Background: In the primary analysis of the CLEAR study, lenvatinib plus pembrolizumab significantly improved progression-free survival and overall survival versus sunitinib in patients with advanced renal cell carcinoma (data cutoff Aug 28, 2020). We aimed to assess overall survival based on 7 months of additional follow-up.
Methods: This is a protocol-prespecified updated overall survival analysis (data cutoff March 31, 2021) of the open-label, phase 3, randomised CLEAR trial.