Kidney cancer is about 2-3% all new cases of cancer and there has been a steady increase in its worldwide 2 decades.
Twice as common in men
Kidney cancer is usually diagnosed in people in between 50 and 70 years. There are over 400.000 New cases of kidney cancer are diagnosed worldwide every year. From those, renal cell carcinoma (RCC) is the most common type of kidney cancer, representing approximately the 90% of cases.
It is a form of cancer that is twice as common in men. If detected in the early stages, the five-year survival rate is high, but for patients with metastatic RCC, the survival rate is much lower, about 12%. In Greece more than 1.000 patients get kidney cancer every year.
Kidney cancer symptoms and risk factors
According to information from the Institute for the Study of Urological Diseases, in the early stages, unfortunately, rarely there are symptoms, and these may not be appreciated, such as an episode of hematuria or a feeling of heaviness to the right or left of the waist. As the tumor increases in size and depending on its location in the kidney.
The most common symptoms that can occur are:
- Haematuria (presence of blood in the urine, which is either visible to the naked eye or detected in the laboratory).
- Pain in the ribs in the area of the kidneys that does not subside.
- Palpable mass in the abdomen.
- Unexplained weight loss.
- Weakness, payment and fever that can not be attributed to another cause.
As for the risk factors for kidney cancer these are smoking, obesity, unregulated hypertension and less occupational exposure to toxic agents, the tribe, heredity. About the latter, the most common inherited predisposition is Von Hippel-Lindau disease, which is a familial hereditary cancer syndrome.
THE “silent killer”
This characterization was given to kidney cancer by Dr.. Ioannis Boukovinas, Pathologist - Oncologist, President of EOPE, which focused on epidemiological data. “Kidney cancer is the 14th most common cancer worldwide with a median age of diagnosis of 64 years. The incidence of kidney cancer worldwide and at European level has increased by 2% the latest 20 years, and the mortality rate is rising in many countries including Greece. Over the last few years the introduction of new therapies into clinical practice has helped patients live longer and live better”, he said.
An important new treatment for kidney cancer
IPSEN, global biopharmaceutical group focusing on innovation and specialist care, informed in a press conference that the European Medicines Agency approved on 31 Of March 2021 Cabozantinib in combination with Nivolumab as a first-line treatment for patients with advanced kidney cancer. This decision marks the first approval for Cabozantinib in combination with another treatment in Europe and the third indication for this drug in renal cell carcinoma. (RCC).
The main issue of the approval of the combination was focused by Dr.. Aristotle Bamias, Professor of Oncology - Pathology EKPA presenting the data of the study and noting that “The combination of Cabozantinib with Nivolumab is the latest, but certainly not the last, achievement in continued progress in the systematic treatment of metastatic kidney cancer. It is a very effective treatment regimen, which significantly improves patient survival with a well-tolerated safety profile. Our therapeutic quiver in this disease is constantly being enriched lately 15 years with new innovative drugs. Greek patients also have access to all these medicines. At the same time our patients have the opportunity, due to the conduct of many clinical trials in our country on access to innovative drugs, even before their approval by the regulatory authorities”.
Approval of the Cabozantinib combination, of a multimolecular inhibitor of multiple tyrosine kinases, and Nivolumab, of a monoclonal antibody against PD-1, two drugs that had previously been approved for metastatic kidney cancer as monotherapy, based on the results of the phase III clinical trial CheckMate 9ER announced at the ESMO conference in September 2020 and was recently published in the New England Journal of Medicine.
The study showed that Cabozantinib in combination with Nivolumab almost doubled disease-free survival (PFS) and significantly improved overall survival(YOU) the patients. Median survival without disease progression with the combination was 16.6 months versus 8.3 months in his arm. The difference in overall survival was also impressive, although at the time of study analysis the median survival was not achieved in either part of the study, The combination of Cabozantinib and Nivolumab appears to reduce the risk of death by 34%. The increase in the percentage of objective responses to 55,7% in favor of the combination of Nivolumab and Cabozantinib versus just 28% for Sunitinib, with 9,3% of patients to show complete imaging depression. The predominance of the combination was observed in all subgroups of the study, was independent of patient prognostic group and PDL1 expression.
The safety profile of the combination was consistent with the safety profiles of the drugs individually. The tolerance of the combination is also reflected in the improved quality of life of patients receiving Cabozantinib and Nivolumab compared to Sunitinib., as it was recorded based on predefined questionnaires during treatment, showing a clear reduction in the worsening of disease-related symptoms.
The combination Cabozantinib - Nivolumab is a recommended treatment option in the updated guidelines of the European Society of Oncology (ESMO) and is now available in our country.