Kidney Cancer

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[Kidney Cancer @IntKidneyCancer]

Good morning everyone this is the link of the Italian Kidney Cancer group ❤️
Athos MANDRELLI

https://t.co/stJiHsHEt7

[GU Oncology Now @GUOncologyNow]

💡 ICYMI from #ASCO26: The addition of Radium-223 fails to improve symptomatic skeletal event–free survival in #renalcellcarcinoma with bone metastases: https://t.co/0zxJGtLvrh

[Uromigos @Uromigos]

The adjuvant RAMPART trial by James Larkin opens new areas of debate in the adjuvant renal cancer field. #ASCO26 https://t.co/IjcRiOrlNF

[ari hakimi @arihakimi]

Why do VEGFR-TKI + IO combinations produce impressive responses in ccRCC but often fail to achieve the long-term durability seen with dual checkpoint blockade? Check out our lab's latest in @Cancer_Cell led by the incredible Lyn Vuong!
https://t.co/ASvkCpDzQW

[Pavlos Msaouel @PavlosMsaouel]

Fascinating case @Shounak_Gupta expanding our understanding of MiT/TFE altered #kidneycancer

[Toni Choueiri, MD @DrChoueiri]

Great presentation by Dr. Pavlos Msaouel. Panitumumab-based EGFR blockade in SMARCB1-deficient renal medullary carcinoma: ORR 53.9% (15.4% CR) and mOS 9.5 mo in heavily pretreated pts, far exceeding historical benchmarks. Wild-type EGFR dependency as a new therapeutic vulnerability in this rare, aggressive disease. #ASCO26 #RCC @OncoAlert @ASCO @OncBrothers

[Dra. María Natalia Gandur Quiroga @nataliagandur]

#ASCO26 GU Oncology Spotlight 🚨

🔬 Abstract 4521 | CaboNivo in non–clear cell RCC
Final results of phase 2 cabozantinib + nivolumab in patients with non–clear cell renal cell carcinoma
Presented by Darren R. Feldman, MD
@ASCO
@OncoAlert
Important final dataset in a difficult RCC space.

Non–clear cell RCC represents a biologically diverse group of kidney cancers, often with fewer prospective data and historically poorer outcomes than clear cell RCC.
🔵 Study design
Investigator-initiated phase 2 study:

➡️ cabozantinib 40 mg daily
➡️ nivolumab 240 mg q2w or 480 mg q4w

Cohort 1 included:

• papillary RCC
• FH-deficient RCC
• unclassified RCC
• translocation-associated RCC

Chromophobe RCC was evaluated separately and closed early for inefficacy.

🟢 Final efficacy signal
With longer follow-up of ~50 months, CaboNivo reaffirmed antitumor activity in non–clear cell RCC.

In cohort 1:

• N = 53
• PR/CR: 43%
• median PFS: 11 months
• median OS: 28 months
Responses were seen across several non–clear cell histologies, with a particularly notable signal in FH-deficient RCC:
➡️ 7/8 patients had an objective response.
🔵 Why it matters

Non–clear cell RCC is not one disease.

Histology matters.

Biology matters.

And prospective treatment data remain limited.

This final analysis supports cabozantinib + nivolumab as an active regimen for selected patients with non–clear cell RCC histologies, especially papillary, FH-deficient, unclassified, and translocation-associated disease.
🟠 Safety
Toxicity was consistent with known cabozantinib + nivolumab profiles.
Grade 3/4 treatment-emergent AEs occurred in a substantial proportion of patients, and discontinuations due to AEs occurred with cabozantinib, nivolumab, or both.

So this is active therapy — but not low-burden therapy.

🧠 My take

CaboNivo is one of the more clinically useful prospective datasets in non–clear cell RCC.

The key message is not “treat all non–clear cell RCC the same.”

It is:

➡️ use histology
➡️ recognize biologic subgroups
➡️ avoid assuming clear-cell algorithms fully apply
➡️ consider CaboNivo as a treatment option where prospective evidence supports activity
➡️ continue building trials specific to rare RCC subtypes

For non–clear cell RCC, better classification is the beginning of better treatment.

#ASCO26 #GUOnc #KidneyCancer #RCC #NonClearCellRCC #PapillaryRCC #FHdeficientRCC #Cabozantinib #Nivolumab #PrecisionOncology

@OncLive @TargetedOnc @CancerNetwrk @ASCOPost @ecancer @VJOncology @curetoday @JCO_ASCO

[Katy Beckermann @katy_beckermann]

Does the PFS benefit of len + eve come with a body composition cost?

AI-based CT segmentation at L3 in post-IO ccRCC (phase II RCT, n=66):

After 4 months, len + eve associated with significantly greater losses in:
🔬 Skeletal muscle mass index: OR 0.30, p=0.014
🔬 Subcutaneous adiposity: OR 0.21, p=0.002
🔬 BMI: OR 0.36, p=0.026

QOL by FKSI-DRS was inconclusive between arms at day 60. Standard instruments may not capture what is happening at the tissue level.

AI-assisted CT phenotyping could be a new tool to understand treatment

Congrats @onchahn.

#RCC #KidneyCancer #GUonc #ASCO26

[International Urology Cancer Summit @urologysummit]

🟠#ASCO26 GU discussion
RCC with symptomatic bone metastases remains a difficult real-world scenario, especially where access to multidisciplinary bone care is variable.
📙Abstract 4500 | RADICAL
Cabozantinib ± radium-223 did not improve SSE-FS. @ASCO @DrRanaMcKay
@urotoday

[Tom Powles @tompowles1]

Clear cell RCC sheds low levels of ctDNA, but positivity and ctDNA dynamics are relevant in the adjuvant setting @DrChoueiri #ASCO26. This analysis is with an exome based personalised technique and shows a lack of sensitivity (5-8% ctDNA+ve rate vs 40% radiological relapse rate) but good specificity (almost all ctDNA +ves relapse). Whole genome ctDNA analysis should work work better. There is a future for ctDNA in renal cancer, we’re just not quite there yet IMO.

[marco stellato @marcos130990]

ctDNA in renal cell carcinoma: have we reached a turning point? Still many questions ahead — sensitivity, timing, clinical utility — but the field is clearly evolving fast. Great talk by @DrChoueiri
#renalcellcarcinoma #ctDNA

[Dana-Farber @DanaFarber]

We’re kicking off day one of #ASCO26 with @DrChoueiri highlighting ctDNA findings from the KEYNOTE-564 trial in kidney cancer, examining patients treated with adjuvant pembrolizumab or placebo after surgery.

[Karine Tawagi MD @DrKarineTawagi]

First in class PD1/CTLA4 bispecific ph1 in nccRCC #ASCO26

➡️37 pts, ORR 51.6% esp in liver mets, mPFS 16.7 mo

⛔️ heterogeneity & high FH def population, no DLTs

✅promising 1L and manageable safety, not ready for clinic, but reinforces IO/TKI in nccRCC, driven by FH-def

[David K. Calsina Quispe @david_cals17344]

@DrKarineTawagi @DrChoueiri @PGrivasMDPhD @IntKidneyCancer @KidneyCancer @NazliDizman @AmandaNizamMD @bergsa83 @ASCO @neerajaiims @PBarataMD @apolo_andrea Interesting! 😊Thank you very much. A comparison with other oncological diseases.

[UroToday.com @urotoday]

PEAK-1: A randomized, double-blind, active-control, multicenter phase 3 trial of casdatifan and cabozantinib vs PBO and cabozantinib in patients with advanced clear cell #RCC. Upcoming poster presentation by @DrChoueiri @DanaFarber. #ASCO26 written coverage by @chavarriagaj @PSH_Urology > https://t.co/L6V29oTx8I @ASCO

[Sumanta K. Pal, MD, FASCO @montypal]

Thank you @AmandaNizamMD for highlighting this important study! So cool to see original trials by @NazliDizman & @EbrahimiHedyeh leading to a P3 trial led by @PBarataMD via @SWOG! #ASCO26 @oncoalert

[Enrique Grande @drenriquegrande]

⚡️ Phase 3 LITESPARK-022 in high-risk ccRCC after nephrectomy: adjuvant pembrolizumab + belzutifan vs pembrolizumab alone (n=1,841).

24-month DFS: 80.7% vs 73.7% (HR 0.72; P=0.0003).

First phase 3 adjuvant trial to demonstrate DFS benefit vs pembrolizumab monotherapy — a potential new standard of care.

#KidneyCancer

https://t.co/Y0gVbiAUDG

[Tom Powles @tompowles1]

Renal cancer highlights #ASCO26 1) RAMPART - adjuvant durva/tremi vs durva vs surveillance. How much does CTLA4 help? 2) Is ctDNA useful post surgery in RCC (KN565 data)? 3) Does radium-223 help in bone mets patients? (a RII study) 4) Data on 2 VEGF+PD1 combination single arm studies in papillary RCC.

[Sara Coca Membribes @scocmem]

Looking forward to this #ASCO26 presentation by
@BethN01 addressing an important topic we see more and more in clinic: how patients perceive long-term toxicity and decision regret after adjuvant immunotherapy in RCC.

[Sara Elena Rebuzzi @RebuzziSara]

Finally published!!! 😃 The assessment of the Meet-URO score in a first-line mRCC international cohort. Thanks to @gbanna74 @amg120395
https://t.co/abJQJ7S4h1

[Cristiane D Bergerot, PhD, FASCO @crisbergerot]

Do patients with bone metastases derive sustained benefit from first-line immunotherapy-based combinations in advanced RCC? #ASCO26 @ASCO @apolo_andrea
Updated subgroup analyses from CheckMate-9ER and long-term outcomes with cabozantinib + nivolumab

https://t.co/p9S16JvnCy