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Clinical data from 15-year UCLA study helps physicians personalize kidney-cancer therapy


Kidney Cancer Grid UCLA research developed a staging system that groups patients according to their risk of cancer recurrence and mortality. The graph shows disease-specific survival (n = 1453) for low-, intermediate- and high-risk patients with metalistic (M) and nonmetastatic (NM) kidney cancer.

Researcher at UCLA’s Jonsson Cancer Center have developed an integrated staging system that separates kidney-cancer patients into distinct treatment groups based on their risk for cancer recurrence and mortality. With separate categories for patients who have localized and metastatic disease, the system identifies patients as having low, intermediate or high risk for cancer recurrence and mortality.

A recently published study of nearly 1,500 patients treated for kidney cancer at UCLA in the last 15 years shows that an aggressive treatment regimen based on patients’ individual staging groups results in better survival rates than a “one-size-fits-all” approach.

The study, which appears in the Nov. 1, 2008, issue of Cancer, the peer-reviewed journal of the American Cancer Society, is the longest to date to analyze kidney- cancer patients and their outcomes.

Individualized treatment

In the past, treatment decisions have frequently been based on whether the cancer has spread beyond the kidneys. This approach failed to recognize the variety that exists within each of these broad patient categories.

Using clinical staging of the patient and pathological staging of the tumor, UCLA physicians have demonstrated the ability to further categorize patients into groups with low, intermediate or high risk of cancer recurrence and mortality. This further categorization helps physicians personalize kidney-cancer therapy to achieve the best results while minimizing undesirable side effects.

For example, the UCLA research shows that patients with low-risk, localized kidney cancer can be treated with surgery only and expect an excellent outcome. This spares the patient from having to undergo radiation or immunotherapy, which can carry harsh side effects. However, for a patient with high-risk, localized kidney cancer, surgery would not be enough. Additional therapy, such as targeted treatments or immunotherapy, should be considered in order to give the patient the best possible outcome.

In metastatic patients, someone with low-risk cancer should get very aggressive treatment, as there’s a good chance the therapy will help the patient. Those with high-risk, metastatic disease won’t get much, if any, benefit from treatment and may want to forego surgery and the toxic therapies.

The UCLA program

The multidisciplinary UCLA Kidney Cancer Program brings together a complete range of medical and surgical services into a coordinated consultation and treatment program that offers state-of-the-art care along with access to the latest investigational treatments. Patients are seen in the renowned Clark Urology Center at UCLA, where they benefit from the convenience of evaluation by multiple experts in a single visit. The program offers a one-stop clinic with specialists in urology, medical oncology, radiology, nephrology and endocrinology.

UCLA physicians are experts in laparoscopic and robotic surgeries and in performing difficult and complex kidney-cancer surgeries. As an elite center of academic research, UCLA either originates or actively participates in virtually all significant clinical studies of promising new treatments for kidney cancer. UCLA kidney-cancer physicians can evaluate patients to determine if they are suitable candidates to participate in one or more of UCLA’s ongoing trials.

New UCLA system informs treatment decisions

“Not all localized kidney cancers are the same and not all metastatic kidney cancers are the same,” explains Arie Belldegrun, M.D., professor of urology and a researcher at UCLA’s Jonsson Comprehensive Cancer Center.

Identifying patients based on their risk of recurrence and mortality helps physicians decide what treatment regimen would be most beneficial to that patient. This includes not exposing patients to therapies associated with harsh side effects unless the treatment is likely to benefit them.

“We showed that we can identify which patients fall into which groups,” says Dr. Belldegrun. “Now we can make treatment decisions based on that.”

Participating Physicians

Arie Belldegrun, M.D., FACS
Surgical Director, UCLA Kidney Cancer Program
Roy and Carol Doumani Chair in Urologic Oncology
Professor of Urology
Chief, Division of Urologic Oncology

Fairooz Kabbinavar, M.D.
Medical Director, UCLA Kidney Cancer Program
Associate Professor, Department of Medicine,
Division of Hematology-Oncology

Allan Pantuck, M.D., FACS
Director, Translational Research
Associate Professor of Urology

Contact Information

UCLA Kidney Cancer Program
(310) 794-7700 Appointments
(310) 794-7787 Fax

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