Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Myelodysplasia risk high in RCC patients

Shenoy N et al. Clinical Genitourinary Cancer, Published online June 28, 2018. https://doi.org/10.1016/j.clgc.2018.06.008

Key clinical point: Patients with a history of renal cell carcinoma have a substantially increased risk of developing myelodysplastic syndromes as compared to the general population. Given the strong association, an unexplained cytopenia in patients with a history of nephrectomy for localized RCC would warrant a strong consideration for a bone marrow biopsy to detect myelodysplasia.

Major finding: The prevalence of myelodysplastic syndromes in patients over 65 years old with a history of nephrectomy for RCC was 8.4 times that of the age-concordant general population based on the Dusseldorf registry (28/6490 or 395/100,000 vs. 47/100,000), and 3.07 times that of the age-concordant patient population at Mayo Clinic (28/6490 or 395/100,000 vs 128.4/100,000. Both differences were statistically significant (P less than 0.001).

Study details: Mayo Clinic’s ‘Advanced Cohort Explorer’ database was used to identify patients with a history of both malignancies. Prevalence of myelodysplastic syndromes was noted in patients aged 65 years and older with a history of nephrectomy for RCC and was compared to the prevalence of myelodysplastic syndromes in the Dusseldorf MDS registry and the general patient population at Mayo Clinic.

Disclosures: The authors had no relevant financial disclosures.

Source: Shenoy N et al. Clinical Genitourinary Cancer, Published online June 28, 2018. https://doi.org/10.1016/j.clgc.2018.06.008

Citation:

Shenoy N et al. Clinical Genitourinary Cancer, Published online June 28, 2018. https://doi.org/10.1016/j.clgc.2018.06.008

This Week's Must Reads

First-line avelumab/axitinib for RCC benefits wide range of patients, Choueiri TK et al. GUCS 2019, Abstract 544.

Inadequate emergency care a challenge for rural pediatric patients, Walling EB et al. J Oncol Pract. 2019 Jan 31. doi: 10.1200/JOP.18.00115.

QC measures improve with CMS Oncology Care Model, Rocque G et al. J Oncol Pract. 2019. doi: 10. 1200/JOP.18.00390.

Must Reads in Renal Cell Carcinoma

First-line avelumab/axitinib for RCC benefits wide range of patients, Choueiri TK et al. GUCS 2019, Abstract 544.

Strong link found between RCC and melanoma, Kim KB et al. Cancer Epidemiol. 2018 Oct 19;57:80-4

Apo B/A1 predicts survival in metastatic renal cell carcinoma, Zhang F et al. Urol Oncol. 2018 Nov 30. doi: 10.1016/j.urolonc.2018.11.010

RCC patients with brain-only metastases may benefit from cytoreductive nephrectomy, Daugherty M et al. Urol Oncol. 2018 Dec 5.doi: 10.1016/j.urolonc.2018.10.021

Lower concentration of pazopanib linked with less toxicity, Noda S et al. Clin Genitourin Cancer. 2018 Dec 7. doi: 10.1016/j.clgc.2018.12.001