Publications by authors named "Shuch B"
Modern advances in systemic and localized therapies for patients with renal cell carcinoma (RCC) have significantly improved patients' outcomes. If disease progression occurs after initial treatment, clinicians often have multiple options for a first salvage therapy. Because salvage and initial treatments both may affect overall survival time, and they may interact in unanticipated ways, there is a growing need to determine sequences of initial therapy and first salvage therapy that maximize overall survival while maintaining quality of life.
View Article and Find Full Text PDFBackground And Objective: This review aims to provide an overview of novel diagnostic and therapeutic radiopharmaceuticals tested recently or used currently in genitourinary cancers within prospective phase 1-2 clinical trials, summarizing progresses and future directions.
Methods: A systematic search was conducted using the PubMed/MEDLINE and ClinicalTrials.gov databases for original prospective research studies following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.
Article Synopsis
- * Five pediatric patients with VHL-associated hemangioblastomas were treated with belzutifan, leading to improvements in tumor size and vision for those with retinal lesions, and benefits in neurologic symptoms for patients with intracranial tumors.
- * The treatment resulted in minor side effects, such as grade 1-2 anemia in four patients, and suggests belzutifan could be a promising therapy for young patients with these tumors.
Article Synopsis
- The CheckMate 914 trial investigated the effectiveness of adjuvant nivolumab monotherapy compared to placebo in patients with localized renal cell carcinoma (RCC) at high risk of recurrence after surgery.
- Despite enrolling 825 patients, the results showed that nivolumab did not significantly improve disease-free survival (DFS) compared to placebo.
- Additionally, safety data indicated that adverse events were reported at different rates among the treatment groups, but overall, the trial did not achieve its primary goal of improved DFS for nivolumab.
Article Synopsis
- The study investigates the use of a radioactive monoclonal antibody, [Zr]Zr-girentuximab, for non-invasive detection of clear-cell renal cell carcinoma in patients with renal masses.
- Conducted across 36 sites in nine countries, the phase 3 trial involved 332 enrolled patients with suspicious renal masses, who received the antibody followed by PET-CT imaging.
- The primary goals of the trial were to assess the sensitivity and specificity of the imaging technique using histopathological confirmation as the standard, with findings from 300 patients eventually analyzed.
JCO Mesenchymal-epithelial transition (MET) signaling pathway plays a role in the pathogenesis of selected patients with papillary renal cell carcinoma (PRCC). In the phase II PAPMET trial (ClinicalTrials.gov identifier: NCT02761057), cabozantinib significantly prolonged progression-free survival and improved objective response rate compared with sunitinib in patients with advanced PRCC.
View Article and Find Full Text PDFImportance: Clinical trial data on adjuvant therapy in patients with non-clear cell renal cell carcinoma (RCC) are scant.
Objective: To evaluate the effect of adjuvant everolimus after nephrectomy on recurrence-free survival (RFS) and overall survival (OS) in patients with localized papillary and chromophobe RCC.
Design, Setting, And Participants: This prespecified subgroup analysis of a phase 3 randomized clinical trial, EVEREST, included patients enrolled between April 1, 2011, and September 15, 2016.
Objective: To evaluate the clinical significance of subtyping (type 1 vs 2) of papillary renal cell carcinoma (PRCC) in patients treated with targeted therapy, as well as the concordance, sensitivity and positive predictive value (PPV) of local review pathology review.
Methods: Patients with advanced refractory PRCC were randomised to receive sunitinib or cabozantinib, crizotinib or savolitinib, stratified by PRCC subtype (type 1, type 2, or not otherwise specified [NOS]/mixed) by local review. Central review was retrospectively conducted by three expert genitourinary pathologists who independently reviewed cases.
Objectives: To evaluate the effectiveness of cryoablation compared to partial nephrectomy in patients with stage IA papillary and chromophobe renal cell carcinoma (pRCC; chRCC).
Material And Methods: The 2004-2016 National Cancer Database was queried for adult patients with stage IA pRCC or chRCC treated with cryoablation or partial nephrectomy. Patients receiving systemic therapy or radiotherapy, as well as those with bilateral RCC or prior malignant disease were excluded.
Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is caused by loss of function mutations in fumarate hydratase (FH) and results in an aggressive subtype of renal cell carcinoma with limited treatment options. Loss of FH leads to accumulation of fumarate, an oncometabolite that disrupts multiple cellular processes and drives tumor progression. High levels of fumarate inhibit alpha ketoglutarate-dependent dioxygenases, including the ten-eleven translocation (TET) enzymes, and can lead to global DNA hypermethylation.
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- The study investigated the effectiveness of nivolumab, an immunotherapy drug, used before and after surgery in patients with high-risk renal cell carcinoma compared to traditional surgery alone.
- It was a randomized phase 3 trial involving 819 patients across multiple sites in the US and Canada, who were assigned to either the nivolumab plus surgery group or surgery only group.
- The primary outcome measured was recurrence-free survival, with safety being assessed for all patients who started treatment, and the trial has been officially closed to new participants.
Article Synopsis
- The EVEREST trial investigated the effectiveness of adjuvant everolimus in patients with intermediate-high to very high risk of recurrence after kidney cancer surgery, showing a significant improvement in recurrence-free survival (RFS) but not in overall survival (OS).
- Of the 699 patients analyzed with very high-risk clear cell histology, those taking everolimus experienced a notable increase in RFS (HR 0.80) compared to placebo, although a high percentage (47%) of patients on everolimus discontinued treatment due to side effects.
- While everolimus improved RFS, the lack of statistically significant OS benefits suggests that further examination is needed to assess its long-term survival impact
Objective: To meet the increasing demands of genetic risk assessment for genitourinary cancers due to expanded clinical guidelines, we established an academic/industry partnership to create a streamlined workflow to overcome the barriers to access to care.
Materials And Methods: Genome Medical offers multilingual genetic counseling. A pilot program evaluated patients at risk for hereditary genitourinary syndromes.
Article Synopsis
- Renal cell carcinoma (RCC) with sarcomatoid and rhabdoid features exhibits aggressive behavior and poor prognosis, yet is not classified as a separate type in the 2022 WHO classification.
- Sarcomatoid RCC is characterized by malignant spindle cells, while rhabdoid cells display distinct eccentric nuclei and large inclusions, both showing unique molecular features that indicate a clonal evolution.
- New immunotherapy treatments targeting PD-1/PD-L1/CTLA-4 have shown promise, highlighting the importance of recognizing these specific tumor features for better management and treatment outcomes.
Background: Fermented soy products have shown to possess inhibitory effects on prostate cancer (PCa). We evaluated the effect of a fermented soy beverage (Q-Can®), containing medium-chain triglycerides, ketones and soy isoflavones, among men with localized PCa prior to radical prostatectomy.
Methods: We conducted a placebo-controlled, double-blind randomized trial of Q-Can®.
Here, in a multi-ancestry genome-wide association study meta-analysis of kidney cancer (29,020 cases and 835,670 controls), we identified 63 susceptibility regions (50 novel) containing 108 independent risk loci. In analyses stratified by subtype, 52 regions (78 loci) were associated with clear cell renal cell carcinoma (RCC) and 6 regions (7 loci) with papillary RCC. Notably, we report a variant common in African ancestry individuals ( rs7629500 ) in the 3' untranslated region of VHL, nearly tripling clear cell RCC risk (odds ratio 2.
View Article and Find Full Text PDFThe NCCN Guidelines for Kidney Cancer provide multidisciplinary recommendations for diagnostic workup, staging, and treatment of patients with renal cell carcinoma (RCC). These NCCN Guidelines Insights focus on the systemic therapy options for patients with advanced RCC and summarize the new clinical data evaluated by the NCCN panel for the recommended therapies in Version 2.2024 of the NCCN Guidelines for Kidney Cancer.
View Article and Find Full Text PDFApproximately 65% of renal cell carcinomas (RCC) are diagnosed at a localized stage. We investigated the chromosome 5q gain impact on disease-free survival (DFS) in RCC patients. Overall, 676 patients with stages 1-2 RCC and having cytogenetic analysis were included.
View Article and Find Full Text PDFBackground: CD70 is commonly overexpressed in renal cell carcinoma and is minimally expressed in normal human tissue, making it a potential therapeutic target for patients with advanced renal cell carcinoma. The expression frequency of CD70 in metastatic renal cell carcinoma is not well established.
Materials And Methods: We assessed CD70 immunohistochemistry in 391 primary renal tumors and 72 metastatic renal cell carcinomas on a tissue microarray including 26 sets of paired primary and metastatic tumors.
Background: Minorities diminished returns theory posits that socioeconomic attainment conveys fewer health benefits for Black than White individuals. The current study evaluates the effects of social constructs on resection rates and survival for non-small cell lung cancer (NSCLC).
Methods: Patients with potentially resectable NSCLC stage IA to IIIA were identified using the 2004 to 2017 National Cancer Database.
Background: Surgical resection is the standard of care for early-stage non-small cell lung cancer. Black patients have higher surgical refusal rates than White patients. We evaluated factors associated with the refusal of resection and subsequent non-small cell lung cancer outcomes.
View Article and Find Full Text PDFThis is a summary of a research article reporting Part A of the CheckMate 914 study (NCT03138512; EudraCT 2016-004502-34). Following surgery to remove renal cell carcinoma (RCC), people with a high risk of the cancer returning received nivolumab plus ipilimumab (adjuvant therapy) or placebo to see if this risk was reduced. The results of this study showed that the risk of RCC returning or death was not changed with adjuvant nivolumab plus ipilimumab treatment compared with placebo.
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- The study investigated the effectiveness of everolimus, a drug that inhibits the mammalian target of rapamycin, in preventing disease relapse in patients who had surgery for renal cell carcinoma.
- Conducted as a randomized, double-blind trial, 1545 adult participants at high risk of recurrence were assigned to receive either everolimus or a placebo after their surgery, with a focus on measuring recurrence-free survival over a median follow-up of 76 months.
- Results showed that everolimus improved recurrence-free survival (5-year rates of 67% vs. 63%) but did not reach the statistical significance needed, while it was particularly beneficial for those in the very-high-risk category, although it was associated with significantly more