Page 17 - CUA KIDNEY CANCER HANDBOOK 2020

Management of Advanced or

Metastatic Kidney Cancer

Patient Identification and

Multidisciplinary Evaluation

• Patients are best served by an oncologist specialist as the prescribing
physician, who is knowledgeable about the disease, the drug and drug
interactions, toxicities and monitoring
● • A multidisciplinary team, including nursing care, dietary care and pharmacy
support, should be involved in patient management
● • Frequent patient evaluation is necessary to ensure toxicities are recognized and
managed appropriately
● • Information on prevention and management of potential side effects should be
provided to patients/caregivers

Risk-Stratification

• Critical first step in therapeutic decision-making in patients who require
systemic therapy for advanced or metastatic renal cell carcinoma (mRCC)
is risk stratification
● • Risk-stratification score based on information from the International Metastatic
Renal Cell Carcinoma Database Consortium (IMDC) published by Heng and
colleagues
– Set of six IMDC criteria

– Recommended tool for patient counselling and treatment selection
● • IMDC classification is a prognostic classification tool (provides an estimate of
survival) as well as a tool to determine eligibility for ipilimumab-nivolumab and
other combinations

Practical Approaches to Managing Advanced Kidney Cancer 11