Renal Cell Carcinoma

Question 1

Papillary RCC is associated with what mutation?

Answer 1

MET

Question 2

Papillary RCC is associated with what mutation?

Answer 2

Met

Question 3

Stage I RCC is:

Answer 3

T1N0M0
Less than 7 cm

Question 4

Stage II RCC is:

Answer 4

T2N0M0
More than 7 cm, confined to kidney

Question 5

Stage III RCC is:

Answer 5

T11-2, N1 or T3 N0-1
T3 means extending outside kidney

Question 6

What is T4 RCC?

Answer 6

Invasion beyond Gerota’s fascia

Question 7

T4N0 is what stage RCC?

Answer 7

IV

Question 8

What 5 things make up the IMDC prognostic model?

Answer 8

KPS <80
Anemia
HyperCa
Thrombocytosis
Leukocytosis
Diagnosis to treatment <1 year

Question 9

Treatment for Stage 1-2 RCC?

Answer 9

Nephrectomy (partial or radical)
Partial is preferred in Stage I

Question 10

Stage 3 RCC treatment

Answer 10

Radical Nephrectomy, adjuvant Pembro for high risk

Question 11

Whwat patients are eligible for adjuvant Pembro? (5)

Answer 11

pT2, grade 4 or sarcomatoid
pT3, any grade
pT4, any grade
Any N+
Also patient with complete resection of oligometastatic disease

Question 12

Which patients with metastatic disease should you consider an upfront nephrectomy?

Answer 12

Minimal metastatic burden with easily resectable primary

Question 13

4 preferred 1L treatment options for mRCC?

Answer 13

Ipi/Nivo
Cabo/Nivo
Pembro/Len
Axi/Pembro

Question 14

Ipi/Nivo is not good for what subpopulation of patients with mRCC?

Answer 14

Bone mets

Question 15

What is the survival benefit for VEGF TKI + ICI in favorable risk mRCC?

Answer 15

No OS benefit, but PFS benefit

Question 16

2L options for mRCC in those with prior IO therapy (5)

Answer 16

Axitinib
Belzutifan
Cabo
Everolimus + L:envatinib

Question 17

Indication for Tivozanib

Answer 17

3L mRCC

Question 18

3 treatment options for 1L m non-ccRCC

Answer 18

Pem/Len
Cabo/Nivo
Cabo

Question 19

VHL disease causes what clinical features?

Answer 19

RCC
Pancreatic NET
Renal cysts
Hemangioblastomas (retinal, cerebellar, spinal)

Question 20

Treatment for VHL-associated RCC?

Answer 20

Belzutifan

Question 21

Preferred treatment for renal angiomyolipomas associated with TSC

Answer 21

Everolimus

Question 22

Mutation associated with hereditary papillary RCC

Answer 22

MET

Question 23

Mutation in Birt Hogg Dube syndrome

Answer 23

FLCN

Question 24

RCC plus spontaneous pneumothorax should make you think of what syndrome?

Answer 24

Birt Hogg Dube syndrome

Question 25

What are 3 1L monotherapy options for favorable risk mRCC?

Answer 25

Pazopanib
Sunitinib
Axitinib

Question 26

What are 3 1L monotherapy options for poor/intermediate risk RCC?

Answer 26

Cabozantinib (best monotherapy)
Pazopanib
Sunitinib

Question 27

2L options in mRCC in ICI-naive patients (7)

Answer 27

Axi Pembro
Cabo
Cabo Nivo
Ipi Nivo
Everolimus Len
Pembro Len
Nivo