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.

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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.

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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.

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