Renal cell cancer Flashcards Preview

BPT Oncology > Renal cell cancer > Flashcards

Flashcards in Renal cell cancer Deck (9)
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1
Q

What are some pathological types?

A
Clear cell 75% 
Papillary type 1 5%
Papillary type 2 10%
Chromophobe 
Oncocytoma
2
Q

Which gene is associated with clear cell?

A

von Hippel-Lindau - in 50-90%

3
Q

What does VHL mutation lead to?

A

Leads to angiogenesis

4
Q

What are some prognostic factors?

A

Motzer score (older)

IMDC - International metastatic RCC database consortium

5
Q

What is the current therapy for met RCC?

A

Tyrosine kinase inhibitors targeting VEGF-R

  • Sunitinib
  • Pazopanib
  • Cabozantinib
  • Lenvatinib
  • Sorafenib

Immunotherapy - combination therapy

  • PD1 - nivolumab
  • CTLA-4 - ipilimumab

Mammalian target of rapamycin (mTOR) inhibitors

6
Q

What are toxicities of VEGF-R TKIs?

A

GI - mucositis, stomatitis, diarrhoea

Skin - hand-foot syndrome

Hypothyroidism

CV: CCF, MI, VTE, QT prolongation

Often lower grade

7
Q

What are the toxicities of immune checkpoint inhibitors?

A

Less common, unpredictable, often high grade

8
Q

What is first line for favourable risk and intermediate/poor rsk?

A

Favourable: sunitinib or pazopanib

Intermediate/poor: ipilimumab + nivolumab

9
Q

What is the role of cytoreductive nephrectomy in met. RCC?

A

TKI alone is non-inferior in CARMENA study

Consider in symptomatic primary
Or large primary, small metastatic burden