An interdisciplinary consensus on the management of brain metastases in patients with renal cell carcinoma.
Elshad HasanovDebra Nana YeboaMathew D TuckerTodd A SwansonThomas Hendrix BeckhamBrian RiniChibawanye I EneMerve HasanovSophie DerksMarion SmitsShaan DudaniDaniel Y C HengPriscilla K BrastianosAxel BexSahin HanaliogluJeffrey S WeinbergLaure HirschMaria I CarloAyal AizerPaul David BrownMehmet Asim BilenEric Lin ChangJerry JaboinJames BrugarolasToni K ChoueiriMichael B AtkinsBradley A McGregorLia M HalaszToral R PatelScott G SoltysDavid F McDermottJames Bradley ElderMustafa K BaskayaJames B YuRobert TimmermanMichelle Miran KimMelike MutJames MarkertKathryn BealNizar M TannirGeorge SamandourasFrederick F LangRachel GilesEric JonaschPublished in: CA: a cancer journal for clinicians (2022)
Brain metastases are a challenging manifestation of renal cell carcinoma. We have a limited understanding of brain metastasis tumor and immune biology, drivers of resistance to systemic treatment, and their overall poor prognosis. Current data support a multimodal treatment strategy with radiation treatment and/or surgery. Nonetheless, the optimal approach for the management of brain metastases from renal cell carcinoma remains unclear. To improve patient care, the authors sought to standardize practical management strategies. They performed an unstructured literature review and elaborated on the current management strategies through an international group of experts from different disciplines assembled via the network of the International Kidney Cancer Coalition. Experts from different disciplines were administered a survey to answer questions related to current challenges and unmet patient needs. On the basis of the integrated approach of literature review and survey study results, the authors built algorithms for the management of single and multiple brain metastases in patients with renal cell carcinoma. The literature review, consensus statements, and algorithms presented in this report can serve as a framework guiding treatment decisions for patients. CA Cancer J Clin. 2022;72:454-489.
Keyphrases
- brain metastases
- renal cell carcinoma
- small cell lung cancer
- poor prognosis
- case report
- machine learning
- long non coding rna
- squamous cell carcinoma
- young adults
- multiple sclerosis
- deep learning
- ejection fraction
- chronic kidney disease
- papillary thyroid
- acute coronary syndrome
- atrial fibrillation
- blood brain barrier
- patient reported outcomes
- combination therapy
- white matter
- smoking cessation
- clinical practice
- lymph node metastasis