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At the International Kidney Cancer Symposium (IKCS) in North America last week, there was a multidisciplinary session about the treatment of rare subtypes of kidney cancer. The main take home messages from this session were as follows:
For people with collecting duct, sarcomatoid, and rhabdoid subtypes of kidney cancer:
- Immunotherapy, in particular anti-PD-1 medicines such as pembrolizumab or nivolumab are the the standard of care as the first treatment for advanced kidney cancer with sarcomatoid and rhabdoid features
- Clinical trials should be considered for people with collecting duct carcinoma. For this subtype of kidney cancer, the standard of care is chemotherapy, such as gemcitabine plus platinum.
For people with translocation subtype of kidney cancer:
- Translocation kidney cancer can be frequently misdiagnosed as other subtypes of kidney cancer. An accurate diagnosis of this subtype of kidney cancer needs genetic testing
- There are no clear treatment guidelines for translocation kidney cancer and this remains a major unmet medical need.
For people with renal medullary cancer:
- Renal medullary carcinoma responds to chemotherapy but not to targeted therapies, like tyrosine kinase inhibitors (TKIs) or immunotherapy
- The first treatment recommended for most patients in platinum-based chemotherapy, including people with localised disease.