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Tom Powles on new ESMO guidelines for renal cancer
May 23, 2024, 07:58

Tom Powles on new ESMO guidelines for renal cancer

Tom Powles, Director of Barts Cancer Center, shared on X:

“New ESMO guidelines in advanced papillary renal cancer. While there is randomised data supporting Cabozantinib (PFS not OS). Sunitinib is still weakly supported. The single arm Len/pem and Cabo/nivo data look more active and is also recommended. 2nd line data is needed. .

Tom Powles

Updated clear cell renal cancer guidelines by ESMO. Ipi/nivo now has additional weak support in IMDC good risk (I,C). Belzutifan gets strong support in 3rd line (I,B) but less strong 2nd line (VEGF TKI preferred). 1st line PD1/VEGF unchanged.

Tom Powles

The ESMO guidelines make a clear distinction between papillary and other ‘non-clear cell’ renal cancers. Mixing these together has hampered new treatments. Sarcomatoid needs upfront PD1 combos. Other subgroups (chromaphobe etc). Need more data.

Tom Powles

Tom Powles

The ESMO guidelines gives a stronger support (I,A) for adjuvant pembrolizumab in appropriate intermediate and high risk renal cancer due to positive OS signal. Belzutifan is also recommended in VHL germ line altered localised RCC.”

Tom Powles