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Systemic treatment for non- clear cell histology Alessandra Mosca Medical Oncology

Systemic treatment for non- clear cell histology Alessandra Mosca Medical Oncology «Maggiore della Carità» University Hospital University of East Piedmont “A. Avogadro” Novara. (+). (-). HIF, VEGF. De Vita VT el al, 2005 . Sporadic/hereditary.

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Systemic treatment for non- clear cell histology Alessandra Mosca Medical Oncology

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  1. Systemic treatment for non-clearcellhistology Alessandra Mosca MedicalOncology «Maggiore della Carità» University Hospital University of East Piedmont “A. Avogadro” Novara

  2. (+) (-) HIF, VEGF De Vita VT el al, 2005 Sporadic/hereditary (Sporadic)/hereditary (hereditary leiomyomatosis)

  3. Linehan et al, Annu Rev Med 2010

  4. Histology clear cell clear cell clear cell 124 pts (20%) non-clear cell clear cell clear cell clear cell Axitinib vs Sorafenib 723 2nd line PFS 6.7 vs 4.7 mo (p<0.0001) clearcell 8Rini BI et al, Lancet 2011

  5. CLINICAL TRIALS CONSIDERING NON-CLEAR CELL RCC

  6. NEW CLINICAL TRIALS FOR NON-CLEAR CELL RCC: COMPLETED -I-

  7. NEW CLINICAL TRIALS FOR NON-CLEAR CELL RCC: COMPLETED -II-

  8. NEW CLINICAL TRIALS FOR NON-CLEAR CELL RCC: ONGOING

  9. UP DATE FROM

  10. 894/2076 (43%) pts ineligible for clinical trials

  11. Adapted from Heng D et al, ASCO GU 2012

  12. Adapted from Heng D et al, ASCO GU 2012

  13. Adapted from Heng D et al, ASCO GU 2012

  14. Adapted from Heng D et al, ASCO GU 2012

  15. 25 non-clearcell 132 clearcell treated with TT: mediansurvival 15.4 mo (non-clear) vs 35 mo (clear) p=0.007 Non-clearcellhistology remains a significant and independent riskfactor for cancerspecificdeath for mRCCptstreated by TT

  16. 37 pts -> intermittent schedule 37 pts -> daily schedule Adverseevents: -Hypertension 50% -Pulmonaryembolism 11% -Fatigue 6.8% -Diarrhea 6.8%

  17. Adapted from Choueiri TK et al, ASCO GU 2012

  18. 67/74 ptsevaluable for both MET mutationand response to Foretinib: 5/10 (50%) ptswith germlineMET mutation: PR 5/10 (50%) ptswith germlineMET mutation: SD 5/57 (9%) ptswithout germlineMET mutation: PR 1/5 (20%) pts with somatic MET mutation: PR

  19. Sporadic papillary RCC is different from hereditary papillary RCC?

  20. CONCLUSIONS -I- Adapted from Cho D, ASCO GU 2012

  21. CONCLUSIONS -II- Adapted from Cho D, ASCO GU 2012

  22. CONCLUSIONS -III- Multidisciplinaryapproach to RCC patients (Pathologist, Urologist, Oncologist, Radiologist, Statistician, Nurse, …)

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