BCOP Renal cancer Exam Questions with Correct Answers| Latest Update Guaranteed Success
Treatment Options for RCC: #1 Surgery - always if possible
#2 Systemic Therapy in Adv in Unresectable Stage 4 Dz ONLY or Relapse Dz
NO adjuvant therapy even with nodal involvment OR partial resection - no OS benefit seen
XRT in non-adv dz if not surgery candidate
XRT pallative therapy
First Line RCC Options: 1. Clinical Trial
2. Sunitinib
3. Temsirolimus (if poor risk)
4. Avastin PLUS IFN-alpha
5. Pazopanib
6. IL-2 - selected group:
good PF, can't take PDGFR/VEGFR OR mTOR
inhibitors
7. Sorafenib - selected group:
want inc QOL vs IFN-alpha
side note: axitinib being tested currently in 1st line - for now MUST fail 1st line therapy prior to
axitinib!
What is Poor-risk group per MSKCC risk Model? ATLEAST 3 of following:
1. LDH >1.5ULN
2. Hg <LLN
3. Corrected Ca >10mg/dL
, 4. 2 or more sites of mets
5. Performance Status <70
6. Time from Diagnosis --> Systemic Tx was > 1 year
note: 0 = favorable (good), 1-2 = intermediate, >3 = poor
Sunitnib MOA & Dose = Multikinase inhibitor (mainly PDGFR and VEGFR)
50mg po QD x 4 weeks on and 2 weeks off
*with or without food*
dose adjust by 12.5mg for SE
alternative regimens: giving more freq and shorter drug holidays = great tolerablity and
response rates
Sunitinib Side Effects = *Hypothyroidism* (seen in 45-85%, onset 4-94 weeks, longer than
sorafenib)
HTN
Diarrhea
Handfoot syndrome - (VEGF-R inhibitor class effect)
Transaminase Elevations
Taste alterations
Decrease platelets
Sunitinib compared to Pazoponib Both are NON-inferior to each other, but
ALL SE are less with Pazoponib, EXCEPT Transaminase Elevation
Treatment Options for RCC: #1 Surgery - always if possible
#2 Systemic Therapy in Adv in Unresectable Stage 4 Dz ONLY or Relapse Dz
NO adjuvant therapy even with nodal involvment OR partial resection - no OS benefit seen
XRT in non-adv dz if not surgery candidate
XRT pallative therapy
First Line RCC Options: 1. Clinical Trial
2. Sunitinib
3. Temsirolimus (if poor risk)
4. Avastin PLUS IFN-alpha
5. Pazopanib
6. IL-2 - selected group:
good PF, can't take PDGFR/VEGFR OR mTOR
inhibitors
7. Sorafenib - selected group:
want inc QOL vs IFN-alpha
side note: axitinib being tested currently in 1st line - for now MUST fail 1st line therapy prior to
axitinib!
What is Poor-risk group per MSKCC risk Model? ATLEAST 3 of following:
1. LDH >1.5ULN
2. Hg <LLN
3. Corrected Ca >10mg/dL
, 4. 2 or more sites of mets
5. Performance Status <70
6. Time from Diagnosis --> Systemic Tx was > 1 year
note: 0 = favorable (good), 1-2 = intermediate, >3 = poor
Sunitnib MOA & Dose = Multikinase inhibitor (mainly PDGFR and VEGFR)
50mg po QD x 4 weeks on and 2 weeks off
*with or without food*
dose adjust by 12.5mg for SE
alternative regimens: giving more freq and shorter drug holidays = great tolerablity and
response rates
Sunitinib Side Effects = *Hypothyroidism* (seen in 45-85%, onset 4-94 weeks, longer than
sorafenib)
HTN
Diarrhea
Handfoot syndrome - (VEGF-R inhibitor class effect)
Transaminase Elevations
Taste alterations
Decrease platelets
Sunitinib compared to Pazoponib Both are NON-inferior to each other, but
ALL SE are less with Pazoponib, EXCEPT Transaminase Elevation
