Kidney cancer highlights from AUA 2023

Below are some of the research highlights from the 2023 American Urological Association Annual Meeting held on April 28 – May 1 in Chicago, Illinois. 

Successful imaging of very small renal lesions

New data from the phase III Zircon trial on small renal mass diagnostic imaging showed the ability to differentiate cancerous lesions from non-cancerous ones in a subgroup of very small kidney lesions 2 cm or less. Zircon, sponsored by Telix Pharmaceuticals, previously reported positive results at the 2023 ASCO GU meeting earlier this year in the use of the zirconium-tagged antibody girentuximab (89Zr-DFO-girentuximab) to differentiate cancerous vs non-cancerous kidney lesions with a sensitivity and specificity of 86% and 87%, respectively, which was higher than the FDA-set baseline rates. Secondary endpoints in lesions 4 cm or less were met as well but an exploratory cohort of very small lesions of 2 cm or less (48 patients) showed sensitivity was 84% and specificity was 92.3-100%. Thus far the results are limited to identification in patients with clear cell renal cell carcinoma and the negative predictive value needs clarification. Overall, small renal masses are difficult to diagnose with about a quarter of those with lesions 4 cm or less undergoing unnecessary biopsy. Better imaging agents may be able to spare patients invasive surgery, stressful monitoring periods, and there is ongoing work on the use of such imaging in staging. [AUA 23 LBA03-01. Read more.]

Papillary RCC patients don’t benefit from clear cell treatment options

People with metastatic papillary RCC do not have improved overall survival with immunotherapy, targeted therapy, or combination therapy, compared with targeted therapy alone. This look into real-world use trends included one National Cancer Database query that identified 737 metastatic papillary RCC patients who had received either targeted therapy, immunotherapy, or immunotherapy plus targeted therapy. While cytoreductive nephrectomy was associated with benefit in overall survival, neither immunotherapy nor the combination therapy was associated with better overall survival compared with targeted therapy alone. Current treatment for papillary RCC patients is based on studies of clear cell RCC, for which standard of care is immunotherapy with or without targeted therapy. However, these combinations have not been explored in papillary RCC. [AUA 23 MP28-14. Read more.]