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dc.contributor.authorRothermundt, C
dc.contributor.authorvon Rappard, J
dc.contributor.authorEisen, T
dc.contributor.authorEscudier, B
dc.contributor.authorGrünwald, V
dc.contributor.authorLarkin, J
dc.contributor.authorMcDermott, D
dc.contributor.authorOldenburg, J
dc.contributor.authorPorta, C
dc.contributor.authorRini, B
dc.contributor.authorSchmidinger, M
dc.contributor.authorSternberg, CN
dc.contributor.authorPutora, PM
dc.date.accessioned2017-04-13T09:54:36Z
dc.date.issued2017-04
dc.identifier.citationWorld journal of urology, 2017, 35 (4), pp. 641 - 648
dc.identifier.issn0724-4983
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/593
dc.identifier.eissn1433-8726
dc.identifier.doi10.1007/s00345-016-1903-6
dc.description.abstractBackground Second-line systemic treatment options for metastatic clear cell renal cell cancer (mccRCC) are diverse and treatment strategies are variable among experts. Our aim was to investigate the approach for the second-line treatment after first-line therapy with a tyrosine kinase inhibitor (TKI). Recently two phase III trials have demonstrated a potential role for nivolumab (NIV) and cabozantinib (CAB) in this setting. We aimed to estimate the impact of these trials on clinical decision making.Materials and methods Eleven international experts were asked to provide their treatment strategies for second-line systemic therapy for mccRCC in the current setting and once NIV and CAB will be approved and available. The treatment strategies were analyzed with the objective consensus approach.Results The analysis of the decision trees revealed everolimus (EVE), axitinib (AXI), NIV and TKI switch (sTKI) as therapeutic options after first-line TKI therapy in the current situation and mostly NIV and CAB in the future setting. The most commonly used criteria for treatment decisions were duration of response, TKI tolerance and zugzwang a composite of several related criteria.Conclusion In contrast to the first-line setting, recommendations for second-line systemic treatment of mccRCC among experts were not as heterogeneous. The agents mostly used after disease progression on a first-line TKI included: EVE, AXI, NIV and sTKI. In the future setting of NIV and CAB availability, NIV was the most commonly chosen drug, whereas several experts identified situations where CAB would be preferred.
dc.formatPrint-Electronic
dc.format.extent641 - 648
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://www.rioxx.net/licenses/all-rights-reserved
dc.subjectHumans
dc.subjectCarcinoma, Renal Cell
dc.subjectKidney Neoplasms
dc.subjectAnilides
dc.subjectImidazoles
dc.subjectIndazoles
dc.subjectPyridines
dc.subjectAntineoplastic Agents
dc.subjectAntibodies, Monoclonal
dc.subjectProtein Kinase Inhibitors
dc.subjectTreatment Failure
dc.subjectConsensus
dc.subjectAlgorithms
dc.subjectDecision Support Techniques
dc.subjectDecision Trees
dc.subjectEverolimus
dc.subjectNivolumab
dc.subjectAxitinib
dc.titleSecond-line treatment for metastatic clear cell renal cell cancer: experts' consensus algorithms.
dc.typeJournal Article
dcterms.dateAccepted2016-07-19
rioxxterms.versionofrecord10.1007/s00345-016-1903-6
rioxxterms.licenseref.urihttps://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2017-04
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfWorld journal of urology
pubs.issue4
pubs.notes12 months
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Melanoma and Kidney Cancer
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Melanoma and Kidney Cancer/Melanoma and Kidney Cancer (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Melanoma and Kidney Cancer
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Melanoma and Kidney Cancer/Melanoma and Kidney Cancer (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume35
pubs.embargo.terms12 months
icr.researchteamMelanoma and Kidney Canceren_US
dc.contributor.icrauthorLarkin, James
dc.contributor.icrauthorMarsden,


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