Clinical Edge

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

This Enzyme Appears to Predict RCC Death Risk

J Clin Oncol; 2017 Nov 10; Ho, Kapur, et al

A specific enzyme appears to predict renal cell carcinoma death risk better than existing methods, according to an analysis involving nearly 2,000 individuals. It seems to be particularly accurate in low- and intermediate-risk tumors. Investigators looked at the impact tumor-based enhancer of zeste homolog 2 (EZH2) gene and protein expression had on overall survival in participants from 3 cohorts. Among the results:

  • Patients from the Cancer Genome Atlas with EZH2-high gene expression were 50% more likely to experience overall death than those with low expression.
  • Overall death risk in the University of Texas Southwestern Medical Center cohort was twice as high as those with low expression.
  • It was 40% higher in the Mayo Clinic cohort.
  • Patients in the Mayo group with EZH2-high protein expression were twice as likely to experience RCC-specific death.
  • EZH2 protein expression was particularly prognostic in patients with low-risk tumors.

Citation:

Ho T, Kapur P, Eckel-Passow J, et al. Multicenter validation of enhancer of zeste homolog 2 expression as an independent prognostic marker in localized clear cell renal cell carcinoma. J Clin Oncol. 2017;35(32):3706-3713. doi:10.1200/JCO.2017.73.3238.

This Week's Must Reads

Healthcare.gov open enrollment picks up in Week 2, Weekly enrollment snapshot on CMS.gov

Trump administration takes contradictory actions on ACA, A press statement issued on CMS.gov.

Doctors raise concerns about administration's Part B drug plan, A CMS Fact Sheet on the ANPRM International Pricing Index Model for Medicare Part B Drugs

Guideline authors inconsistently disclose conflicts, Combs T et al. JAMA Intern Med. 2018 Oct 29. doi: 10.1001/jamainternmed.2018.4730. Khan R et al. JAMA Intern Med. 2018 Oct 29. doi: 10.1001/jamainternmed.2018.5106

Must Reads in Renal Cell Carcinoma

PFS superior with avelumab and axitinib in advanced RCC, Motzer RJ et al. ESMO 2018. Abstract LBA6_PR

Adjuvant axitinib may benefit highest risk RCC patients, Quinn DI et al. Ann Oncol. 2018 Oct 20. doi: 10.1093/annonc/mdy454

High KPNA2 signals poor outcomes for RCC, Kristiansen G et al. Clin Genitourin Cancer. 2018 Oct 22. doi: 10.1016/j.clgc.2018.10.008

RCC patient and disease characteristics differ by race/ethnicity, Batai K et al. Clin Genitourin Cancer. 2018 Oct 26. doi: 10.1016/j.clgc.2018.10.012

Change in tumor burden signals treatment needs in mRCC, Bimbatti D et al. Urol Oncol. 2018 Oct 6. doi: 10.1016/j.urolonc.2018.08.018