New guide adds options for kidney cancer

"Temsirolimus [Torisel, Wyeth] is now recommended as a first-line treatment [category 1] option in renal cell cancer patients with predominant clear cell histology who also have poor Memorial Sloan-Kettering Cancer Center [MSKCC] prognostic risk factors," said Cheryl A. Grandinetti, Pharm.D., senior clinical research pharmacist at the National Cancer Institute's Cancer Therapy Evaluation Program. NCCN has included temsirolimus as first-line therapy for patients with non-clear cell histology, she added.

In the new document, the term second-line therapy has been changed to subsequent therapy and the category designations for sunitinib (Sutent, Pfizer) and sorafenib (Nexavar, Bayer) were clarified. Although clinical trials are preferred for subsequent therapy for metastatic disease, both drugs are considered category 1 when used after cytokine therapy and are considered category 2B when used after a prior kinase inhibitor.

Removed from the previous guideline was a first-line recommendation for use of interferon and low-dose interleukin-2 to treat patients with relapsed or stage IV and medically and surgically unresectable cancer with predominant clear cell histology.

"Updating these guidelines is important to the NCCN mission and goals," Grandinetti concluded. According to its purpose statement, NCCN develops scientific, evaluative information to inform and improve decisions that can lead to better care. The new NCCN Kidney Cancer Guidelines can be accessed on-line at http://www.nccn.org/.