Glimmers of new treatment approaches, tantalizing clues as to what may be on the horizon to expand the spectrum of options in immunotherapy, including checkpoint inhibitors, and emerging results from the ESPN trial represent just a small snapshot of this year’s 2014 meeting of the American Society of Clinical Oncology (ASCO). Kidney Cancer Journal assembled a panel of experts to quickly offer their impressions of what was significant at the Scientific Sessions this year, and their encapsulating and concise observations provide some insightful comments as a postscript to the meeting.
Once again, judging from the preponderance of evidence submitted in their comments, immunotherapy seemed to be the pace setter—a theme repeated from last year. In one scientific session at ASCO on checkpoint inhibitors, we obtained more in-depth information on the antibody inhibitors of CTLA-4, PD-1, and PD-L1. These agents may mount a challenge to acceptable first-line therapies but that remains to be prospectively proven in future larger trials. The level of interest in the potential of inhibiting these immune pathways guarantees that subsequent sessions of ASCO will be highly attended to see whether concerns about toxicity can be resolved and whether a checkpoint inhibitor could be inserted into the treatment algorithm, either alone or in combination, at least in second line setting.
I urge you to examine the comments from our panel and judge for yourself what course management is likely to take as these new modalities possibly become available over the next few years. All of these directions will be explored in greater depth in the next issue of the journal as a key investigator examines the implications of a broad range of data presented in various sessions.
But if you are looking now for more in-depth analysis on RCC topics, then the three articles in this issue would merit your attention. They include:
- A report by Brian Shuch, MD, on early-onset renal cell carcinoma and the evolution in thinking on germline mutational testing in this subset of patients.
- A review by Eric Jonasch, MD, delineating how scheduling of sunitinib-moving from the traditional 4 weeks on 2 weeks off to 2 weeks on 1 week off-is changing our perception of how the use of this agent may be more effectively tailored to minimize the drug’s adverse effects while maintaining optimal outcomes, thereby prolonging duration of therapy.
- A reappraisal of the role of renal mass biopsy by Jaime Landman, MD, whose report demythologizes the traditional thinking about biopsies and suggests how molecular advances have ushered in a new era for this procedure.
I wish to gratefully acknowledge the work of my colleagues in providing content that meets the educational needs of our audience of medical oncologists and urologists.
Jose A. Karam, MD