Contact:jerry.he@wecistanche.com

Cistanche is very good for renal function

Renal cell carcinoma (RCC) is one of the ten most common cancers worldwide, accounting for approximately 2% of all cancers.

01

3% to 5% of renal cell carcinomas are hereditary diseases

Genetic syndromes associated with renal cell carcinoma include VHL syndrome, BAPT1 mutant disease, succinate dehydrogenase-associated renal cancer, hereditary leiomyomatosis, hereditary papillary renal carcinoma, Birt-Hogg-Dubé syndrome, Tuberous sclerosis complex, Cowden syndrome, and hyperparathyroidism.

Genetic counseling should be considered in patients aged 46 years and younger. Younger age and bilateral/multicentric lesions are well-recognized features of hereditary renal cell carcinoma.

02

In certain populations, active surveillance is a reasonable option

Active surveillance is a reasonable initial treatment option for patients with small or Bosniak 3/4 cystic renal cell carcinoma, especially for masses <2 cm.

Physicians should prioritize active monitoring of such patients when the expected risk of intervention outweighs the potential oncological benefit of aggressive treatment.

Physicians should aggressively or repeat imaging studies at 3-6 months in patients with uncertain risks and benefits of treatment or those who prefer active surveillance.

Studies have shown that the 5-year survival rate of patients receiving active surveillance is 70%.

03

Targeted therapy + immunotherapy

Renal cell carcinoma is a chemotherapy-refractory cancer. The treatment options for metastatic clear cell renal carcinoma include targeted therapy or immunotherapy, and new evidence supports the combination of targeted therapy and immunotherapy for metastatic disease.

Currently, targeted therapies for renal cell carcinoma include axitinib, bevacizumab, cabozantinib, lenvatinib, pazopanib, sunitinib, and sorafenib, as well as targeting rapamycin Targeted drugs everolimus and temsirolimus of tincine complex 1 (mTORC1).

The current first-line immunotherapy regimens for advanced renal cell carcinoma include nivolumab + ipilimumab, axitinib + avelumab, and axitinib + pembrolizumab.

In addition, three recent studies have evaluated sunitinib with three immunotherapy-containing regimens (axitinib + pembrolizumab, atezolizumab + bevacizumab, nivolumab) + ipilimumab) in sarcomatoid renal cell carcinoma, and immunocombination therapy was shown to be more effective than sunitinib in all three studies.

04

Folic acid treats common side effects

Mucositis is commonly seen in metastatic renal cell carcinoma treated with targeted therapy and immunotherapy and may affect patients' quality of life or lead to dose reductions or treatment discontinuation.

Physicians may underestimate the severity of mucositis in patients. About 20% of patients receiving targeted therapy develop mucositis, and targeted therapy produces oral mucosal toxicity that differs from the classical oral lesions observed with cytotoxic chemotherapy or radiation. Treatment for mucositis includes good daily oral care and regular dental care.

A recently published small study showed that folic acid significantly reduced the efficacy of sunitinib, pazopanib, everolimus, axitinib, temsirolimus, interleukin-2/interferon-alpha, carbo Grade 2 or higher symptoms of mucositis resulting from treatment with tinib, bevacizumab, and nivolumab. Currently, a double-blind, placebo-controlled prospective study is underway.

05

partial nephrectomy

With the increased detection of smaller (especially <7 cm) renal masses and the development of surgical approaches, both ASCO and NCCN guidelines recommend partial nephrectomy when feasible.

Partial nephrectomy reduced ischemic time and was comparable in reducing the incidence of chronic renal failure, delaying cardiovascular disease, and improving survival.