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Published in Renal Cell Carcinoma

Expert Opinion / Cases · March 01, 2016

Advanced Presentation, Aggressive mRCC: What is the 2nd line Treatment?

Heather Greene MSN, FNP, AOCNP

 

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Heather Greene MSN, FNP, AOCNP

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  • Bradley Somer MD

    Bradley G. Somer MD

    Feb 03, 2016

    With concomitant presentation of metastases at time of discovery of renal mass and what seems like a PFS of 2 months on Sutent, I assume that this patient is adherent to therapy, an assumption which should not generally be made as there is less adherence then we think. However, assuming the patient is taking his therapy, the PFS seems to be prognostically poor, albeit we do not have MSKCC criteria in total posted on this case. I would recheck IMDC criteria to get another perspective on prognosis as able to stratify even in second line. I do think it is reasonable to consider Nivolumab as second line therapy. Based on Checkmate 025, one can expect them to do better than on mTOR inhibitors:  http://www.nejm.org/doi/pdf/10.1056/NEJMoa1510665 and this seems to be standard of care. 

  • jim deaton

    May 10, 2016

    As a second line treatment, why not consider the treatment of the blood with immunotherapy charging of the blood cells to attack the tumors instead of the Nivolumab approach of preventing the tumors in producing the protein inhibitor?

  • Jan 07, 2025

    Pending Moderator approval.
    Delete

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