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Highlights from the 2021 International Kidney Cancer Symposium |
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| Award Lecture |
| Andrew C. Novick Award Lecture
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| Brian Lane, MD, Ph.D.
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| At the 2021 International Kidney Cancer Symposium (IKCS): North America meeting, Brian Lane gave the Andrew C. Novick Award Lecture with a talk focusing on the management of T1 renal masses. In the context of understanding his career trajectory and his clinical and research interests, Dr. Lane began by highlighting the value of his training at the Cleveland Clinic, quoting Charles Dickens to say, “it was the best of times, it was the worst of times”.
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| Impact of Adjuvant IO on 1st Line Therapy |
| Future of Adjuvant Therapy in RCC
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| Toni K. Choueiri, MD
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| In a session focused on the role and effects of adjuvant immunotherapy in renal cell carcinoma (RCC) on subsequent first-line therapy, Toni Choueiri provided an overview of his perspective of the future of adjuvant therapy in this disease space.
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| Non-Clear Cell RCC |
| Phenotypic Characterization of Renal Masses - The Virtual Biopsy
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| Ivan Pedrosa, MD, Ph.D.
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| The International Kidney Cancer Symposium 2021 annual hybrid meeting included a non-clear cell renal cell carcinoma session and a presentation by Dr. Ivan Pedrosa discussing phenotypic characterization of renal masses by a virtual biopsy approach. Virtual biopsy with clear cell likelihood score on MRI can assist in the management of small renal masses, by decreasing the need for percutaneous biopsy and decreasing the benign nephrectomy rate.
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| Surgical Management of Non-Clear Cell in RCC
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| Ronald S. Boris, MD, MS
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| Ronald Boris discussed surgical management of non-clear cell renal cell carcinoma (RCC). Dr. Boris notes that histology matters in the behavior of both local and advanced RCC. Understanding renal tumor subtyping and specific behaviors associated with RCC histology can shape surgical approaches in both the localized and metastatic settings.
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| Use of AI Deep Learning in Histologic Classification
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| Saeed Hassanpour, Ph.D.
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| In this presentation, Saeed Hassanpour discussed the use of artificial intelligence deep learning in histologic classification for renal cell carcinoma (RCC). The motivation for artificial intelligence is that classification of RCC patterns on biopsy and surgical resection slides under the microscope are challenging given that it (i) requires highly specialized expertise, (ii) is time-consuming, (iii) and requires a high degree of variability among pathologists.
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| The Role of NF2 in Tumorigenesis: The Hippo Pathway and Cancer
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| Kun-Liang Guan
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| Kun-Liang Guan discussing the role of NF2 in tumorigenesis and specifically the Hippo pathway and cancer. Dr. Guan highlights that the Hippo pathway plays a key role in organ size control by regulating cell proliferation and apoptosis in Drosophila, the species in which this pathway was first discovered. Dr. Guan also notes that the Hippo pathway is among the newest signaling pathways commonly altered in human cancer.
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| Systemic Therapy for Non-Clear Cell: Recent and Future Studies
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| Bradley McGregor, MD
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| Bradley McGregor discussed recent and future studies of systemic therapy for non-clear cell RCC, highlighting that non-clear cell RCC has worse outcomes than clear cell RCC. There have been multiple advances across non-clear cell RCC subtypes, including VEGF inhibitors, chemotherapy, and combination regimens (ie. immunotherapy, VEGF, mTOR). Histology directed therapy is the ultimate goal.
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| Multimodality Perspectives on Clinical Trials |
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| Health Equity in Clinical Trials
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| Lola Fashoyin-Aje
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| In the session focusing on multimodality perspectives on clinical trials, Dr. Lola Fashoyin-Aje presented on the critical issue of health equity in clinical trials. Dr. Fashoyin-Aje highlighted the present disparities in clinical trial participation. Addressing these offers the opportunity to provide treatment to our patients earlier and generate better data to inform the safe and effective use of new treatments across the entire population.
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| Enhancing Patient Centered Care in Systemic Therapy and Clinical Trials
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| Biren Saraiya, MD
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| Biren Sariaya presented on how we may enhance patient centered care. Dr. Sariaya suggested that shared decision making is the key to ensuring that patient values guide all clinical decisions. This process of shared decision making can help patients evaluate options in the context of what is important to them, rather than in an agnostic climate.
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| Role of Perioperative Therapy in RCC |
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| Use of Artificial Intelligence for Renal Cell Carcinoma Diagnosis of CT Scans |
| Christopher Weight, MD, MS
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| Christopher Weight discussed the use of artificial intelligence for RCC diagnosis of CT scans. There are three ways that CT segmentation can change the clinical practice of kidney cancer according to Dr. Weight: 1)Increase diagnostic certainty and personalized prediction of cancer outcomes. 2) Predict the best surgical approach, perioperative complications and objectify patient counselling. and 3) Predict post-operative renal function. |
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| The Role of IVC Thrombus with SBRT - Neoadjuvant SBRT |
| Raquibul Hannan, MD, Ph.D. |
| Raquibul Hannan discussed the role of neoadjuvant stereotactic body radiotherapy in patients with RCC and IVC tumor thrombus. The only potentially curative treatment for patients with an IVC thrombus is surgical resection, which is associated with a 35% rate of high-grade peri-operative morbidity and 5-13 rate of peri- and post-operative mortality. However, there is an increased risk of relapse and metastasis even after curative resection. |
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| Surgical Considerations with Perioperative Therapy |
| Mohamad Allaf
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| Mohamad Allaf discussing surgical considerations with perioperative therapy. Dr. Allaf notes that TKIs have been used as monotherapy or in combination with immunotherapy in the neoadjuvant setting, adjuvant setting, or both. However, there is an element of overtreatment and toxicity associated with the treatment given that many patients are cured by surgery alone. |
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