Shilpa Gupta Profile picture
Dec 14 22 tweets 155 min read
@TumorBoardTues @MPishvaian 1/18 #TumorBoardTuesday #RenalCancer #OncTwitter

60yo 👴🏽#RenalCell dx in 2022 tx with right radical nephrectomy
6mo f/u
Uses WC d/t DM2 - limited mobility & homebound

🤨 What would be your next step?
@TumorBoardTues @MPishvaian 2/18 #TumorBoardTuesday
🩻Lung nodules, mediastinal lymphadenopathy🫁
🔬: Bx returns as metastatic clear cell #RCC
➡️1st relapse at 6mo f/u

👴🏽 limited mobility and difficult time leaving the house.

🤨 What treatment would you select for this patient?
@TumorBoardTues @MPishvaian @montypal @brian_rini @DrYukselUrun @TiansterZhang @KidneyCancer @HHammersMD @arihakimi @RCCadvocate @AmandaNizamMD @QingZhangLab @DrRanaMcKay @DrScottHaake @DrDavidNanus @PavlosMsaouel @OAlhalabiMD @kcCURE @motzermd @MosheOrnsteinMD @neerajaiims @RenoHemonc @DrChoueiri 4/18 #TumorBoardTuesday
👩🏽‍🏫 Mini Tweetorial 1

Risk criteria used for #RCC are MSKCC prognostic model or Internat’l Met RCC Database Consortium.
Important to determine risk to guide Tx.
Ipi/Nivo ONLY approved for Int/poor risk pts while VEGF-TKI combos are approved for any risk
@TumorBoardTues @MPishvaian @montypal @brian_rini @DrYukselUrun @TiansterZhang @KidneyCancer @HHammersMD @arihakimi @RCCadvocate @AmandaNizamMD @QingZhangLab @DrRanaMcKay @DrScottHaake @DrDavidNanus @PavlosMsaouel @OAlhalabiMD @kcCURE @motzermd @MosheOrnsteinMD @neerajaiims @RenoHemonc @DrChoueiri 5/18 #TumorBoardTuesday
👩🏽‍🏫 Mini Tweetorial 2

💊@NCCN guidelines, all options are category 1 recommendations.


VEGF TKI -IO or IO-IO for poor risk mRCC. If contraindication to IO, only cabo can be used
@TumorBoardTues @MPishvaian @montypal @brian_rini @DrYukselUrun @TiansterZhang @KidneyCancer @HHammersMD @arihakimi @RCCadvocate @AmandaNizamMD @QingZhangLab @DrRanaMcKay @DrScottHaake @DrDavidNanus @PavlosMsaouel @OAlhalabiMD @kcCURE @motzermd @MosheOrnsteinMD @neerajaiims @RenoHemonc @DrChoueiri @NCCN 6/18 #TumorBoardTuesday
👩🏽‍🏫Mini Tweetorial 3

👍🏽Advantages of IO-IO (Ipi/Nivo) include durable long-term responses & avoiding TKI related tox & maintenance nivo an easy to tolerate regimen.

👎🏽Disadvantages include higher risk of irAEs & hospitalization risk due to Ipilimumab.
@TumorBoardTues @MPishvaian @montypal @brian_rini @DrYukselUrun @TiansterZhang @KidneyCancer @HHammersMD @arihakimi @RCCadvocate @AmandaNizamMD @QingZhangLab @DrRanaMcKay @DrScottHaake @DrDavidNanus @PavlosMsaouel @OAlhalabiMD @kcCURE @motzermd @MosheOrnsteinMD @neerajaiims @RenoHemonc @DrChoueiri @NCCN 7/18 #TumorBoardTuesday #RenalCell
👩🏽‍🏫Mini Tweetorial 4

Salvage ipi 🚫as effective as using front-line.

👍🏽Advantages of IO-VEGF TKI combo:⬆️ ORR & ⬇️risk of irAE


👎🏽risk of overlapping tox (GI, liver) with VEGF TKI &IO & challenging to attribute to 1 or both agents.

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More from @shilpaonc

Dec 13
1/ #OncTwitter #NephTwitter
#RenalCell #TumorBoardTuesday #MedTweetorial 🧵
w @brian_rini @shilpaonc @katy_beckermann

🦺TKI/IO safety data
🥽Tox to look 4
⛑AE mgmt

🆓#CME @BonumCe🔗
Support by edu grants from Eisai & @Merck

🟢What's your specialty?
2/ #TumorBoardTuesday #BonumCE #RenalCell #OncTwitter #NephTwitter
🆓#CME info ➕ full ref list🗒️ 👉

✳️The critical elements👇 Image
3/ #TumorBoardTuesday #BonumCE #RenalCell
#OncTwitter #NephTwitter #MedTwitter

🟢 Which of the following TKI/IO combo regimens is 🚫NOT approved by the FDA for the frontline mgmt of #RenalCell carcinoma?
Read 27 tweets

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