NOVITÀ E SEQUENZE TERAPEUTICHE NELLE
NEOPLASIE UROLOGICHE
Carcinoma Renale
Andrea Sbrana
U.O. Oncologia Medica 2 Universitaria Azienda Ospedaliero-Universitaria Pisana
What’s new?
RCC: algoritmo terapeutico
Malattia localizzata o localmente avanzata
Chirurgia radicale (PN/RN ± trombectomia ±
LND ± surrenalectomia)
Terapia adiuvante
?
ASSURE/S-TRAC PROTECT
PROTECT
PROTECT
Amendment
Starting dose passed from 800 to 600 mg daily
PROTECT
PROTECT
PROTECT
Studi in adiuvante
TRIAL Treatment Primary EP Diff in DFS Diff in OS
ASSURE SUN vs SOR vs PLB for 1 yr
DFS NO NO
S-TRAC SUN vs PLB for 1 yr
DFS YES NO
PROTECT PAZ vs PLB for 1 yr
DFS NO NO
EVEREST EVE vs PLB for 1 yr
Awaiting for results
ATLAS AXI vs PLB for 3 yrs
Awaiting for results
PROSPER NIVO (1 mo neo-, 9 mo adj) vs PLB
Recruiting
IMMotion010 ATEZO vs PLB Recruiting
RCC: algoritmo terapeutico
Malattia localizzata o localmente avanzata
Chirurgia radicale (PN/RN ± trombectomia ±
LND ± surrenalectomia)
Terapia adiuvante
?
ASSURE/S-TRAC PROTECT
RCC: algoritmo terapeutico
Malattia metastatica
Nefrectomia citoreduttiva)
Sì?
Quando?
SURTIME
SURTIME
SURTIME
SURTIME
SURTIME
SURTIME
SURTIME
SURTIME
SURTIME
SURTIME
RCC: algoritmo terapeutico
Malattia metastatica
Nefrectomia citoreduttiva
(immediata/differita))
Metastasi resecabili? sì Metastasectomia Osservazione
TERAPIA DI PRIMA LINEA no
RCC: algoritmo terapeutico
CheckMate 214
CheckMate 214
CheckMate 214
CheckMate 214
CheckMate 214
CheckMate 214
CheckMate 214
CheckMate 214
RCC: algoritmo terapeutico
Nivo + Ipi
(interm-/poor risk)
RCC: algoritmo terapeutico
Nivolumab EAP
Nivolumab EAP
Nivolumab EAP
RCC:
prospettive terapeutiche nel mRCC
SUNITINIB ATEZOLIZUMAB
PAZOPANIB PEMBROLIZUMAB
AXITINIB AVELUMAB
LENVATINIB
In PDL1+
(IMMotion 150) hepatotoxicity
RCC:
prospettive terapeutiche nel mRCC
RCC:
prospettive terapeutiche nel mRCC
These data show activity and tolerability of savolitinib in the
subgroup of patients with MET-driven PRCC.
Furthermore, molecular characterization of MET status
was more predictive of response to savolitinib than a
classification based on pathology. These findings justify investigating savolitinib
in MET-driven PRCC.
Grazie per l’attenzione
andreasbrana89@gmail.com
