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Choices and clinical trials in early kidney cancer therapy

Choices and clinical trials in early kidney cancer therapy. E2805 adjuvant sorafenib of sunitinib or placebo post surgery open at CPMC ARISER - Adjuvant Rencarex (WX-G250) intravenous monoclonal antibody available at UCSF .

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Choices and clinical trials in early kidney cancer therapy

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  1. Choices and clinical trials in early kidney cancer therapy E2805 adjuvant sorafenib of sunitinib or placebo post surgery open at CPMC ARISER - Adjuvant Rencarex (WX-G250) intravenous monoclonal antibody available at UCSF

  2. Choices First-line Therapy for Stage IV kidney cancer • High-dose Interleukin-2-most toxic • Sunitinib (Sutent) oral, moderate side effects • Sorabenib (Nexavar) oral, fewer side effects • Bevacizumab with interferon-final data available this summer • Interferon alone- inferior • Temsirolimus (Torisel) probably available this spring • Clinical Trial

  3. Clinical Trials: What and Why • Phase I, Phase II, Phase III-decreasing risk • A biologic experiment with humans • Access to a new therapy that may be better • Access to expertise not available next door • Closer monitoring of your cancer and of treatment side effects • Choose a trial specifically for kidney cancer

  4. Trials at California Kidney Cancer Center 2007 • Renal EFFECT trial--first line stage 4 2 different doses of sunitinib 50mg/day 4weeks on, 2 off 37.5 mg/day, every day • TRIST trial Trovax vaccine with sunitinib • RAD001 trial mTOR inhibitor 2nd, 3rd line versus placebo • E2805 adjuvant study stage 2 or 3 post-op

  5. Choices for second-line therapy Clinical Trial Temsirolimus vs. sorafenib after sunitinib- trial planned Immunotherapy with high-dose IL-2 Change from sorafenib/sunitinib to bevacizumab Change from bevacizumab to sorafenib or sunitinib Change from immunotherapy to targeted therapy Temsirolimus (Torisel)

  6. Combinations of Targeted Therapies • Sorafenib with bevacizumab phase 1 toxicities required dose reductions 42% response rate • Sunitinib with bevacizumab trial in progress • Temsirolimus with bevacizumab trial planned • Temsirolimus with sorafenib in progress Phase III trial planned • Many other combinations possible

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