The appropriateness of the numerous therapeutic options available for patients with advanced or metastatic renal cell carcinoma (RCC) was evaluated in 2011, using the RAND/University of California, Los Angeles (UCLA) appropriateness methodology to match treatment suitability to a range of patient scenarios.
However, the RCC therapeutic area evolves rapidly and a body of new clinical data has accrued in the intervening years; as a result the exercise was repeated in 2013 using the same methodology, expert panel and patient scenarios. The aim of the updated assessment was to update the guidance to clinicians and use it to develop an interactive web-based application, the Renal Cell Carcinoma Appropriateness-based Treatment Toolkit (ReCATT). This round of assessment achieved greater concordance concerning the appropriateness of treatments/interventions for the clinical scenarios tested; this higher level of agreement is likely to reflect the body of scientific evidence accrued since the previous assessment exercise. Many of the areas of disagreement in 2011 related to the suitability of pazopanib or sunitinib treatment; in the 2013 assessment both agents were considered appropriate treatment options for many of the clinical scenarios assessed. Uncertain scenarios often are related to the optimal management of metastatic RCC with clear cell histology. The use of the RAND/UCLA RCC assessment findings to develop the ReCATT support tool will help to disseminate expert opinion concerning best treatment practice and guide the clinical management of RCC patients treated in the community setting.
Written by:
Gore ME, Bellmunt J, Eisen T, Escudier B, Mickisch G, Patard J, Porta C, Ravaud A, Schmidinger M, Schöffski P, Sternberg CN, Szczylik C, Lewis S, Kirpekar S. Are you the author?
Department of Oncology, The Royal Marsden Hospital, Fulham Rd, London SW3 6JJ, UK; Department of Medical Oncology, University Hospital del Mar-IMIM, Barcelona, Spain; Department of Oncology, Cambridge University Health Partners, Cambridge, UK; Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France; Center of Operative Urology Bremen, Bremen, Germany; Department of Urology, Paris XI Bicetre University Hospital, Paris, France; Department of Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, San Matteo University Hospital Foundation, Pavia, Italy; Department of Medical Oncology, Hôpital Saint André, Bordeaux University Hospital, Bordeaux, France; Department of Medicine I, Clinical Division of Oncology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of General Medical Oncology and Laboratory of Experimental Oncology, University Hospitals Leuven, Catholic University Leuven, Leuven, Belgium; Department of Medical Oncology, San Camillo Forlanini Hospital, Rome, Italy; Department of Oncology, Military Medical Institute, Warsaw, Poland; Double Helix Consulting, London, UK.
Reference: Eur J Cancer. 2014 Dec;50(18):3153-60.
doi: 10.1016/j.ejca.2014.09.007
PubMed Abstract
PMID: 25442842