Management of advanced kidney cancer: Canadian Kidney Cancer Forum consensus update

Abstract

Kidney Cancer][3][4] Kidney cancer, predominantly renal cell carcinoma (RCC), is the most lethal genitourinary malignancy and kills more than 1750 Canadians a year. 5 The overall incidence is increasing by 2% per year for unknown reasons, with most new cases being small renal masses.For almost a decade, targeted systemic therapies have been available and have been integrated into clinical practice with evolving experience.Preservation of kidney function with widespread adoption of partial nephrectomy is a focus of treatment of early stage disease.These and other advances have revolutionized care and stimulated research and discovery.[4]6,7 Five previous forums were held in 2008, 2009, 2011, 2013, and 2014.As before, the 2015 meeting was small, by invitation and attended by survivors, caregivers, expert clinicians and researchers in fields relevant to kidney cancer care.The attendees included representatives of Kidney Cancer Canada (www.kidneycancercanada.org). 8 During the conference, prior management consensus statements were reviewed and updated using the same process.This report is an update of the advanced disease management component of the consensus published in 2013. 4The Forum again addressed strategies for kidney cancer control in Canada, which included updates from the now operational Canadian Kidney Cancer Information System (CKCis), as well as reports back from the KCRNC main working groups.These KCRNC groups are working on initiatives in four major domains to improve kidney cancer patient care: (1) personalized medicine; (2) quality care initiatives; (3) survivorship, and (4) genetics.Prior to the start of the Forum, satellite meetings of various working groups also took place, including a new initiative known as the James Lind Alliance (JLA) working group.The JLA is a non-profit organization founded in 2004 that brings together patients, clinicians, and caregivers and through a rigorous process identifies the top 10 uncertainties, or unanswered questions, about a given medical problem. 9he working group established the top 10 uncertainties for kidney cancer management in Canada and we believe this is the first time such an undertaking for kidney cancer has ever happened worldwide and will help inform the working groups on research priorities.This consensus statement pertains to the management of advanced disease.