Renal Cell Carcinoma Flashcards
Papillary RCC is associated with what mutation?
MET
Papillary RCC is associated with what mutation?
Met
Stage I RCC is:
T1N0M0
Less than 7 cm
Stage II RCC is:
T2N0M0
More than 7 cm, confined to kidney
Stage III RCC is:
T11-2, N1 or T3 N0-1
T3 means extending outside kidney
What is T4 RCC?
Invasion beyond Gerota’s fascia
T4N0 is what stage RCC?
IV
What 5 things make up the IMDC prognostic model?
KPS <80
Anemia
HyperCa
Thrombocytosis
Leukocytosis
Diagnosis to treatment <1 year
Treatment for Stage 1-2 RCC?
Nephrectomy (partial or radical)
Partial is preferred in Stage I
Stage 3 RCC treatment
Radical Nephrectomy, adjuvant Pembro for high risk
Whwat patients are eligible for adjuvant Pembro? (5)
pT2, grade 4 or sarcomatoid
pT3, any grade
pT4, any grade
Any N+
Also patient with complete resection of oligometastatic disease
Which patients with metastatic disease should you consider an upfront nephrectomy?
Minimal metastatic burden with easily resectable primary
4 preferred 1L treatment options for mRCC?
Ipi/Nivo
Cabo/Nivo
Pembro/Len
Axi/Pembro
Ipi/Nivo is not good for what subpopulation of patients with mRCC?
Bone mets
What is the survival benefit for VEGF TKI + ICI in favorable risk mRCC?
No OS benefit, but PFS benefit
2L options for mRCC in those with prior IO therapy (5)
Axitinib
Belzutifan
Cabo
Everolimus + L:envatinib
Indication for Tivozanib
3L mRCC
3 treatment options for 1L m non-ccRCC
Pem/Len
Cabo/Nivo
Cabo
VHL disease causes what clinical features?
RCC
Pancreatic NET
Renal cysts
Hemangioblastomas (retinal, cerebellar, spinal)
Treatment for VHL-associated RCC?
Belzutifan
Preferred treatment for renal angiomyolipomas associated with TSC
Everolimus
Mutation associated with hereditary papillary RCC
MET
Mutation in Birt Hogg Dube syndrome
FLCN
RCC plus spontaneous pneumothorax should make you think of what syndrome?
Birt Hogg Dube syndrome
What are 3 1L monotherapy options for favorable risk mRCC?
Pazopanib
Sunitinib
Axitinib
What are 3 1L monotherapy options for poor/intermediate risk RCC?
Cabozantinib (best monotherapy)
Pazopanib
Sunitinib
2L options in mRCC in ICI-naive patients (7)
Axi Pembro
Cabo
Cabo Nivo
Ipi Nivo
Everolimus Len
Pembro Len
Nivo
