Kidney Cancer

Question 1

What are the poor prognostic features of newly diagnosed metastatic renal cell carcinoma ?

Answer 1

Elevated LDH, anemia, hypercalcemia, poor performance status

Question 2

What is the name of the paraneoplastic syndrome and kidney cancer that causes liver enzyme
elevations?

Answer 2

Stauffer syndrome, elevation in AST and ALT with no liver involvement

Question 3

What complications can IVC involvement lead to in metastatic kidney cancer?

Answer 3

Budd Chiari, Pulmonary embolism

Question 4

For RCC what are the size cut-offs for:
 T1
 T2
 T3
 T4

Answer 4

T1 <7 cm
T2 7 - 10 cm
T3 invasion locally excluding Gerota’s fascia and adrenal gland
T4 invasion into Gerota’s fascia and adrenal gland

Question 5

Which protein is mutated in papillary kidney cancer?

Answer 5

MET

Question 6

What is the role of surgery for metastatic kidney cancer?

Answer 6

If greater than or equal to 75% of tumor can be debulked then should be considered

Question 7

Which chemotherapy agents have some activity in metastatic kidney cancer?

Answer 7

Gemcitabine and capecitabine

Question 8

Which 2 proteins are upstream of mTOR?

Answer 8

AKT and PI3K

Question 9

Which tyrosine kinase inhibitors are approved for first line treatment in metastatic kidney cancer?

Answer 9

cabozantinib, sorafenib, sunitinib, pazopanib, lenvatinib, axitinib + PDL1

Question 10

What is the first question to ask when determining first-line therapy for metastatic kidney cancer?

Answer 10

Are they a candidate for immunotherapy?

Question 11

Which viral infection increases the risk for RCC?

Answer 11

Hepatitis C

Question 12

Which renal cell carcinomas are sickle cell anemia patients predisposed to?

Answer 12

Medullary RCC