Renal Articles Flashcards
1
Q
RCC lit
CARMENA
5
A
- cNx + sunitinib has worse OS than sunitinib alone
- RCT 450 pts with met ccRCC (int/poor risk) cNx + sunitinib vs sunitinib alon
- Median OS 19.8 vs 15.6 for sunitinib
- OS better for more advanced disease (2+ IMDC risk factors)
- no difference in response and PFS
NEJM 2018
2
Q
RCC lit
SURTIME
4
A
- Sunitinib + delayed cNX is better than upfront cNx
- RCT 99 pts immediate cNX vs sunitinib and delayed cNxx if no progression
- PFS was the same, OS favored delayed cNx adn avoided cNx in 28% of patients who progressed
- no changes in complications for cNx +/- sunitinib
JAMA Onc 2018
3
Q
RCC lit
KEYNOTE 426
3
A
- Pembro/ Axitinib has better OS regardless of PD-1 status
- RCT 860 pts with untreated ccRCC Pembro + axitinib vs sunitinib
- 1y OS (90% vs 78%), ORR (59% vs 36%), and PFS (15m vs 11m) favored Pembro/axi
NEJM 2019
4
Q
RCC lit
CheckMate 9ER
3
A
- Cabozantinib/ Nivolumab has beeter OS than sunitinib
- RCT 651 pts with untreated advanced or mRCC to cabo/ nivo vs sunitinib
- OS (86 vs 76%), PFS (17m vs 8m), and ORR (56% vs 27%)
NEJM 2021
5
Q
RCC lit
CLEAR
3
A
- Lenvatinib/pembro better than lenvatinib/ temsirolimus better than sunitinib
- RCT 1069 with untreated advanced RCC split to levima/pembro vs levima/ temsirolimus vs sunitinib
- med PFS (24m vs 15 vs 9m…
6
Q
RCC lit
ASSURE
5
A
- Adjuvant targeted therapy (sunitinib or sorafenib) does not improve DFS over placebo
- RCT 1943 patietn wiht HG T1b or greater s/p complete Nx and adequate cardiac/renal/hepatic fxn
- sunitinib vs sorafenib vs placebo
- High toxicity lead to reduced dosing (HF syndroem, HTN , rash, fatigue)
- Stopped early due to side effects with no evidence of DFS improvment
Lancet 2016
7
Q
RCC lit
S-TRAC
4
A
- Adjuvant sunitinib improves median DFS by one year over placebo
- RCT 615 pts with High risk ccRCC got sunitinib 4wweks-on with 2 weeks off vs placebo
- Median DFS was 63.y vs 5.6y
- Significant grade 3 and 4 toxicities (48% and 12%)
NEJM 2016
8
Q
RCC lit
KEYNOTE-564
5
A
- Adjuavant Pembro improves DFS s/p Nx for high risk ccRCC
- RCT 994 pts with high risk ccRCC s/p rNx w/NED post-op
- Pembrolizumab vs placebo q2 weeks up to 1 year
- DFS at 1y 86% vs 76% and 2y 77% vs 68%
- AE 19% vs 1%
NEJM 2021
9
Q
RCC lit
METEOR
5
A
- Cabozantinib has better PFS tahn everolimus for RCC w/progression through TKI
- RCT 658 pts with advanced or mRCC w/cc component s/p VEGFR tx
- cabozantinib vs everolimus
- mPFS 7 vs 4 months
- similar AEs
NEJM 2015
10
Q
RCC lit
COMPARZ
5
A
- Pazopanib in non-inferior to sunitinib with better safety
- RCT 1110pts with met ccRCC
- Pazopanib vs sunitinib
- PFS 8.4 vs 9.5, OS 28 vs 29
- AEs less severe but worse liver enzyme elevation
NEJM 2013
11
Q
RCC lit
CheckMate 214
6
A
- Nivo + Ipi has better OS than sunitinib for int/poor risk pts with untreated RCC
- RCT of 800 pts with untreated int/poor risk RCC w/ cc component
- Ipi+Nivo vs sunitinib
- 18m OS 75% vs 60%
- 42% ORR and 9% CR
- better G3 AEs 46% vs 63%
NEJM 2018
12
Q
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