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The European Association of Urology have recently updated their clinical guidelines for kidney cancer. These are the guidelines that oncologists and urologists (surgeons) follow in the United Kingdom.
The main changes from the 2021 guidelines are as follows:
- Diagnosis of kidney cancer:
- Do not take a kidney biopsy from a kidney cyst unless there is a significant solid portion visible on a scan
- Genetic assessment of kidney cancer:
- Look at the genes in patients aged < 46 years with tumours in both kidneys or multiple tumours in one kidney. And look at the genes of people with kidney cancer in other family members for the diagnosis of hereditary disease
- Refer patients to a cancer geneticist or to a comprehensive clinical care centre in case of suspected hereditary kidney cancer
- Recommendations for immunotherapy in clear cell metastatic kidney cancer:
- Offer nivolumab or cabozantinib for metastatic clear cell kidney cancer patients who have not previously been treated with an immunotherapy and who have stopped responding to vascular endothelial growth factor (VEGF) inhibitors, such as sunitinib, after one or two lines of therapy.