Clinical Edge

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

Stereotactic radiosurgery yields higher overall survival in patients with RCC metastatic to the brain

Haque W et al. Clinical Genitourinary Cancer 3 April 2018 https://doi.org/10.1016/j.clgc.2018.03.015

Key clinical point: Treatment with stereotactic radiosurgery was superior to non-stereotactic radiotherapy for overall survival in patients with renal cell carcinoma metastatic to the brain.

Major finding: Higher overall survival was observed in the stereotactic radiosurgery cohort both before and following propensity matching. On subset analysis, differences persisted when stratifying for nephrectomy (p<0.001 for all). Treatment at an academic center independently predicted a higher rate of overall survival.

Study details: Data for 2005-2014 in the National Cancer Data Base for metastatic RCC and delivery of intracranial radiotherapy found 2,312 patients, 813 (35%) of whom received SRS and 1,499 of whom received non-SRS radiotherapy. Use of SRS increased from 27% in 2005 to 44% in 2014, and was less often given to low income and uninsured/Medicaid patients (p<0.05).

Disclosures: The researchers had no relevant financial disclosures.

Source: Haque W et al. Clinical Genitourinary Cancer 3 April 2018 https://doi.org/10.1016/j.clgc.2018.03.015

Citation:

Haque W et al. Clinical Genitourinary Cancer 3 April 2018 https://doi.org/10.1016/j.clgc.2018.03.015

This Week's Must Reads

Intensity modulated radiation therapy may be preferable in children with extremity nonrhabdomyosarcoma soft-tissue sarcomas, Source: Rao A et al. Intl J Rad Oncology*Biology*Physics; Jan. 2019, 38-44. https://doi.org/10.1016/j.ijrobp.2018.09.005

TAO: Nonwhite ethnicity, limb infection predict poor prognosis, Le Joncour A et al. Arthritis Rheumatol. 2018;70(Suppl 10): Abstract 1885

Thrombolysis for acute ischemic stroke safe in GI malignancy, Inohara T et al. Circulation. 2018 Nov 6;138[suppl 1], Abstract A12291

Ten years of anastrozole boosts disease-free survival, Ohtani S et al. SABCS 2018, Abstract GS3-04

Must Reads in Renal Cell Carcinoma

One-fourth of placebo arm experience adverse events in RCC trials, Chacón M et al. JAMA Network Open. 2018 Dec 7. doi: 10.1001/jamanetworkopen.2018.5617

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