针对罕见亚型患者的策略.pdf

1、Strategies for Patients with Rare SubtypesMehmet Asim Bilen,MD mbilenemory.eduWinship Cancer Institute of Emory UniversityConflict of Interest Advisory board:Exelixis,Bayer,BMS,Eisai,Pfizer,AstraZeneca,Janssen,Calithera Biosciences,Genomic Health,Nektar,EMD Serono,Seagen,and Sanofi Research:Xencor,B

2、ayer,BMS,Genentech/Roche,Seagen,Incyte,Nektar,AstraZeneca,Tricon Pharmaceuticals,Genome&Company,AAA,Peloton Therapeutics,and Pfizer RCC Histologic SubtypesUpdated RCC GuidelinesManagement of localized nccRCCNephrectomyNo evidence for adjuvant therapyEA8252(Pending)Management of metastatic nccRCCCurr

3、ent reality:Although there are different subtypes of nccRCC,we almost exclusively tested ccRCC treatments in nccRCC.Sunitinib in papRCCASPEN Trial:Sunitinib vs.EverolimusArmstrong AJ et al,Lancet Oncol(2016)Cabozantinib in papRCCCabozantinib-nivolumab for nccRCCPembrolizumab plus lenvatinib for nccR

4、CCBergmann L,ESMO 2024Ipilimumab+nivolumab for nccRCCOther combinations in nccRCCHLRCCmPFS:21 mmOS:44 mSporadic papRCCmPFS:8.9 mmOS:18.2 mSrinivasan et al.NEJM 2025Lenvatinib Plus EverolimusOther combinations in nccRCCOther combinations in nccRCCOther combinations in nccRCCSurez C,J Clin Onc(2023)Pe

5、nding trials for ncc-RCCMaughan B,KCRS 2024Pal S,ASCO 2024 Pending trials for ncc-RCCChoueiri T,ESMO 2023Pending trials for ncc-RCCMontenegro et al.KCRS 2024Non-Clear Cell RCC Unanswered Questions Is there a role for adjuvant therapy?(Hope we can activate EA8252)What will be standard optimal frontli

6、ne therapy for metastatic disease?What are options on progression?How applicable are study findings to all histologic subtypes?Limited data for very rare histologies Will a biomarker-driven approach prevail?Summary There are multiple option