An interdisciplinary consensus on the management of brain metastases in patients with renal cell carcinoma

Elshad Hasanov¹, Debra Nana Yeboa², Mathew D Tucker³, Todd A Swanson², Thomas Hendrix Beckham², Brian Rini³, Chibawanye I Ene⁴, Merve Hasanov¹, Sophie Derks⁵, Marion Smits⁵, Shaan Dudani⁶, Daniel Y C Heng⁷, Priscilla K Brastianos⁸, Axel Bex^{9

10

11}, Sahin Hanalioglu¹², Jeffrey S Weinberg⁴, Laure Hirsch^{13

14}, Maria I Carlo¹⁵, Ayal Aizer¹⁶, Paul David Brown¹⁷, Mehmet Asim Bilen^{18

19}, Eric Lin Chang²⁰, Jerry Jaboin²¹, James Brugarolas^{22

23}, Toni K Choueiri¹⁴, Michael B Atkins²⁴, Bradley A McGregor¹⁴, Lia M Halasz²⁵, Toral R Patel^{22

26}, Scott G Soltys²⁷, David F McDermott²⁸, James Bradley Elder²⁹, Mustafa K Baskaya³⁰, James B Yu³¹, Robert Timmerman^{22

32}, Michelle Miran Kim³³, Melike Mut¹², James Markert³⁴, Kathryn Beal³⁵, Nizar M Tannir³⁶, George Samandouras^{37

38}, Frederick F Lang⁴, Rachel Giles³⁹, Eric Jonasch³⁶

Affiliations

¹ Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
² Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
³ Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee.
⁴ Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
⁵ Department of Radiology and Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands.
⁶ Division of Oncology/Hematology, William Osler Health System, Brampton, Ontario, Canada.
⁷ Tom Baker Cancer Center, University of Calgary, Calgary, Alberta, Canada.
⁸ Division of Neuro-Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
⁹ The Royal Free London National Health Service Foundation Trust, London, United Kingdom.
¹⁰ University College London Division of Surgery and Interventional Science, London, United Kingdom.
¹¹ Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
¹² Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
¹³ Department of Medical Oncology, Cochin University Hospital, Public Assistance Hospital of Paris, Paris, France.
¹⁴ Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
¹⁵ Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
¹⁶ Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
¹⁷ Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
¹⁸ Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia.
¹⁹ Winship Cancer Institute of Emory University, Atlanta, Georgia.
²⁰ Department of Radiation Oncology, University of Southern California, Keck School of Medicine, California, Los Angeles.
²¹ Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon.
²² Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, Texas.
²³ Division of Hematology/Oncology, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.
²⁴ Lombardi Comprehensive Cancer Center, MedStar Georgetown University Hospital, Washington, DC.
²⁵ Department of Radiation Oncology, University of Washington, Seattle, Washington.
²⁶ Department of Neurosurgery, The University of Texas Southwestern Medical Center, Dallas, Texas.
²⁷ Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California.
²⁸ Division of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
²⁹ Department of Neurological Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio.
³⁰ Department of Neurological Surgery, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin.
³¹ Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut.
³² Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas.
³³ Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
³⁴ Department of Neurosurgery, The University of Alabama at Birmingham, Birmingham, Alabama.
³⁵ Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
³⁶ Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
³⁷ Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
³⁸ University College London Queen Square Institute of Neurology, University College London, Queen Square, London, United Kingdom.
³⁹ International Kidney Cancer Coalition, Duivendrecht, the Netherlands.

PMID: 35708940
DOI: 10.3322/caac.21729

Free article

Review

An interdisciplinary consensus on the management of brain metastases in patients with renal cell carcinoma

Elshad Hasanov et al. CA Cancer J Clin. 2022 Sep.

Free article

. 2022 Sep;72(5):454-489.

doi: 10.3322/caac.21729. Epub 2022 Jun 16.

Authors

Affiliations

¹ Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
² Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
³ Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee.
⁴ Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
⁵ Department of Radiology and Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands.
⁶ Division of Oncology/Hematology, William Osler Health System, Brampton, Ontario, Canada.
⁷ Tom Baker Cancer Center, University of Calgary, Calgary, Alberta, Canada.
⁸ Division of Neuro-Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
⁹ The Royal Free London National Health Service Foundation Trust, London, United Kingdom.
¹⁰ University College London Division of Surgery and Interventional Science, London, United Kingdom.
¹¹ Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
¹² Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
¹³ Department of Medical Oncology, Cochin University Hospital, Public Assistance Hospital of Paris, Paris, France.
¹⁴ Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
¹⁵ Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
¹⁶ Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
¹⁷ Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
¹⁸ Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia.
¹⁹ Winship Cancer Institute of Emory University, Atlanta, Georgia.
²⁰ Department of Radiation Oncology, University of Southern California, Keck School of Medicine, California, Los Angeles.
²¹ Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon.
²² Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, Texas.
²³ Division of Hematology/Oncology, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.
²⁴ Lombardi Comprehensive Cancer Center, MedStar Georgetown University Hospital, Washington, DC.
²⁵ Department of Radiation Oncology, University of Washington, Seattle, Washington.
²⁶ Department of Neurosurgery, The University of Texas Southwestern Medical Center, Dallas, Texas.
²⁷ Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California.
²⁸ Division of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
²⁹ Department of Neurological Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio.
³⁰ Department of Neurological Surgery, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin.
³¹ Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut.
³² Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas.
³³ Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
³⁴ Department of Neurosurgery, The University of Alabama at Birmingham, Birmingham, Alabama.
³⁵ Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
³⁶ Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
³⁷ Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
³⁸ University College London Queen Square Institute of Neurology, University College London, Queen Square, London, United Kingdom.
³⁹ International Kidney Cancer Coalition, Duivendrecht, the Netherlands.

PMID: 35708940
DOI: 10.3322/caac.21729

Abstract

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.

Keywords: brain metastases; diagnostic evaluation; immune checkpoint blockers; renal cell carcinoma.

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References

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An interdisciplinary consensus on the management of brain metastases in patients with renal cell carcinoma

Affiliations

An interdisciplinary consensus on the management of brain metastases in patients with renal cell carcinoma

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical