Regina Barragan-Carrillo: First and second – line treatments in metastatic renal cell carcinoma

Regina Barragan-Carrillo, Postdoctoral fellow at the Genitourinary Clinic at the Medical Oncology and Medical Therapeutics at City of Hope in Duarte, CA, shared a post on X:

“New Paper Alert!

Excited to share our latest review on first and second -line treatments in mRCC in European Urology, co-authored by Renee Maria Saliby, Eddy Saad, Maxine Sun, and Toni Choueiri among many of the leading experts in the fields.

Check it out!

First and Second-line Treatments in Metastatic Renal Cell Carcinoma

Authors: Regina Barragan-Carrillo, Eddy Saad, Renee Maria Saliby, Maxine Sun, Laurence Albiges, Axel Bex, Daniel Heng, Arnaud Mejean, Robert J. Motzer, Elizabeth R. Plimack, Thomas Powles, Brian I. Rini, Tian Zhang, Toni K. Choueiri.

Our review provides a comprehensive guide for clinicians on selecting first and second-line treatments for mRCC based on current evidence. We evaluated systemic treatment strategies and highlighted key clinical trials.

First-line treatment options include immune ICI-based combinations or oral TKIs. Four combination regimens have been adapted internationally, offering improved outcomes for patients.

Dual ICI combinations offer deep and durable responses, while ICI + TKI combinations provide faster responses and lower primary refractory disease rates.

Sarcomatoid differentiation in RCC is associated with a more aggressive course and poor response to TKIs. ICI-based combinations show superior outcomes in these patients.

In the absence of head-to-head comparisons and approved biomarkers, treatment selection for mRCC is influenced by factors such as IMDC risk, functional status, side-effect profile, and the need for rapid response.

For optimal treatment selection, clinicians must balance efficacy, toxicity, and patient preferences, especially when transitioning between therapies. Personalized care is crucial for improving patient outcomes.

Our review calls for further research on emerging therapeutic options to enhance outcomes and minimize toxicity. The need for standardized second- and third-line treatments remains unmet.

Despite advances in the field, many patients experience disease progression on ICI-based therapy.

Our review emphasizes the need for standardized second-line approaches, with TKIsm, mTORi and HIF2a inhibitors showing promising efficacy.

At this point, there is a lack of evidence supporting ICI rechallenge in the second-line setting for mRCC. Further research is needed to establish effective strategies.

A huge thank you to my coauthors Renee Maria Saliby, Eddy Saad, Maxine Sun, and the entire team led by Toni Choueiri.

Your time, effort, and insights were invaluable. It was an honor working with this team!”

Friends and colleagues congratulated Regina Barragan-Carrillo on her paper.

Toni Choueiri, Director of the Lank Center for Genitourinary Oncology at Dana-Farber Cancer Institute (DFCI).

“We are very proud of this work led by Regina Barragan-Carrillo, City of Hope for the latest updates in metastatic kidney cancer published in the prestigious European Urology journal.

Many super stars joining Regina Barragan-Carrillo with Renee Maria Saliby, Eddy Saad, Maxine Sun, Dana-Farber Lank Center for Genitourinary Oncology co-first authors and several senior experts Tian Zhang, Brian Rini, Laurence Albiges, Tom Powles, Elizabeth Plimack, Robert Motzer, Daniel Heng.

Thank you Alberto Briganti, European Urology for assembling this terrific group.”

Erika Ruiz-Garcia, Professor in the Department of Gastrointestinal Medical Oncology and the Chief of the Translational Medicine Laboratory at the National Institute of Cancerology in Mexico City.

“Congratulations Regina Barragan-Carrillo, Toni Choueiri et al. for this great paper but above all, for supporting talented young oncologists.”

Sumanta Pal, Medical oncologist at City of Hope.

“Insanely proud of Regina Barragan-Carrillo for this masterpiece with senior author Toni Choueiri.

Hats off also to Renee Maria Saliby, Eddy Saad, Maxine Sun (co-first authors) along with the legendary list of coauthors including Tian Zhang, Brian Rini, Laurence Albiges, Tom Powles, Elizabeth Plimack, Robert Motzer, Daniel Heng, (wow! power!).

This piece is a must read for everyone in the field of kidney cancer – kudos to Alberto Briganti, European Urology for assembling this terrific group.

Already missing Dr. Barragan-Carrillo who will leaving us in February to take on a huge role at Instituto Nacional de Cancerología.”