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      Kidney Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology

      1 , 2 , 3 , 4 , 5 , 6 , 1 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 33 , 33
      Journal of the National Comprehensive Cancer Network
      Harborside Press, LLC

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          Abstract

          The NCCN Guidelines for Kidney Cancer focus on the screening, diagnosis, staging, treatment, and management of renal cell carcinoma (RCC). Patients with relapsed or stage IV RCC typically undergo surgery and/or receive systemic therapy. Tumor histology and risk stratification of patients is important in therapy selection. The NCCN Guidelines for Kidney Cancer stratify treatment recommendations by histology; recommendations for first-line treatment of ccRCC are also stratified by risk group. To further guide management of advanced RCC, the NCCN Kidney Cancer Panel has categorized all systemic kidney cancer therapy regimens as “Preferred,” “Other Recommended Regimens,” or “Useful in Certain Circumstances.” This categorization provides guidance on treatment selection by considering the efficacy, safety, evidence, and other factors that play a role in treatment selection. These factors include pre-existing comorbidities, nature of the disease, and in some cases consideration of access to agents. This article summarizes surgical and systemic therapy recommendations for patients with relapsed or stage IV RCC.

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          Most cited references129

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          Cancer Statistics, 2021

          Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence. Incidence data (through 2017) were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data (through 2018) were collected by the National Center for Health Statistics. In 2021, 1,898,160 new cancer cases and 608,570 cancer deaths are projected to occur in the United States. After increasing for most of the 20th century, the cancer death rate has fallen continuously from its peak in 1991 through 2018, for a total decline of 31%, because of reductions in smoking and improvements in early detection and treatment. This translates to 3.2 million fewer cancer deaths than would have occurred if peak rates had persisted. Long-term declines in mortality for the 4 leading cancers have halted for prostate cancer and slowed for breast and colorectal cancers, but accelerated for lung cancer, which accounted for almost one-half of the total mortality decline from 2014 to 2018. The pace of the annual decline in lung cancer mortality doubled from 3.1% during 2009 through 2013 to 5.5% during 2014 through 2018 in men, from 1.8% to 4.4% in women, and from 2.4% to 5% overall. This trend coincides with steady declines in incidence (2.2%-2.3%) but rapid gains in survival specifically for nonsmall cell lung cancer (NSCLC). For example, NSCLC 2-year relative survival increased from 34% for persons diagnosed during 2009 through 2010 to 42% during 2015 through 2016, including absolute increases of 5% to 6% for every stage of diagnosis; survival for small cell lung cancer remained at 14% to 15%. Improved treatment accelerated progress against lung cancer and drove a record drop in overall cancer mortality, despite slowing momentum for other common cancers.
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            Nivolumab plus Ipilimumab versus Sunitinib in Advanced Renal-Cell Carcinoma

            Nivolumab plus ipilimumab produced objective responses in patients with advanced renal-cell carcinoma in a pilot study. This phase 3 trial compared nivolumab plus ipilimumab with sunitinib for previously untreated clear-cell advanced renal-cell carcinoma.
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              Nivolumab versus Everolimus in Advanced Renal-Cell Carcinoma.

              Nivolumab, a programmed death 1 (PD-1) checkpoint inhibitor, was associated with encouraging overall survival in uncontrolled studies involving previously treated patients with advanced renal-cell carcinoma. This randomized, open-label, phase 3 study compared nivolumab with everolimus in patients with renal-cell carcinoma who had received previous treatment.
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                Author and article information

                Journal
                Journal of the National Comprehensive Cancer Network
                Harborside Press, LLC
                1540-1405
                1540-1413
                January 2022
                January 2022
                : 20
                : 1
                : 71-90
                Affiliations
                [1 ]1Memorial Sloan Kettering Cancer Center;
                [2 ]2The University of Texas MD Anderson Cancer Center;
                [3 ]3Huntsman Cancer Institute at the University of Utah;
                [4 ]4University of Michigan Rogel Cancer Center;
                [5 ]5Fred & Pamela Buffet Cancer Center;
                [6 ]6Vanderbilt-Ingram Cancer Center;
                [7 ]7Dana-Farber/Brigham and Women’s Cancer Center;
                [8 ]8Mayo Clinic Cancer Center;
                [9 ]9UC San Diego Moores Cancer Center;
                [10 ]10UCSF Helen Diller Family Comprehensive Cancer Center;
                [11 ]11The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins;
                [12 ]12Roswell Park Comprehensive Cancer Center;
                [13 ]13Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance;
                [14 ]14Abramson Cancer Center at the University of Pennsylvania;
                [15 ]15Stanford Cancer Institute;
                [16 ]16UT Southwestern Simmons Comprehensive Cancer Center;
                [17 ]17University of Wisconsin Carbone Cancer Center;
                [18 ]18University of Colorado Cancer Center;
                [19 ]19UC Davis Comprehensive Cancer Center;
                [20 ]20City of Hope National Medical Center;
                [21 ]21Kidney Cancer Coalition;
                [22 ]22Yale Cancer Center/Smilow Cancer Hospital;
                [23 ]23Moffitt Cancer Center;
                [24 ]24Massachusetts General Hospital Cancer Center;
                [25 ]25The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute;
                [26 ]26O'Neal Comprehensive Cancer Center at UAB;
                [27 ]27Fox Chase Cancer Center;
                [28 ]28Case Comprehensive Cancer Center/ University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute;
                [29 ]29Duke Cancer Institute;
                [30 ]30UCLA Jonsson Comprehensive Cancer Center;
                [31 ]31Siteman Cancer Center at Barnes- Jewish Hospital and Washington University School of Medicine;
                [32 ]32Robert H. Lurie Comprehensive Cancer Center of Northwestern University;
                [33 ]33National Comprehensive Cancer Network.
                Article
                10.6004/jnccn.2022.0001
                34991070
                a4c0bcd7-3716-4633-b456-f9ccc2cfa546
                © 2022
                History

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