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Hasanov E, Yeboa DN, Tucker MD, Swanson TA, Beckham TH, Rini B, Ene CI, Hasanov M, Derks S, Smits M, Dudani S, Heng DYC, Brastianos PK, Bex A, Hanalioglu S, Weinberg JS, Hirsch L, Carlo MI, Aizer A, Brown PD, Bilen MA, Chang EL, Jaboin J, Brugarolas J, Choueiri TK, Atkins MB, McGregor BA, Halasz LM, Patel TR, Soltys SG, McDermott DF, Elder JB, Baskaya MK, Yu JB, Timmerman R, Kim MM, Mut M, Markert J, Beal K, Tannir NM, Samandouras G, Lang FF, Giles R, Jonasch E. An interdisciplinary consensus on the management of brain metastases in patients with renal cell carcinoma. CA Cancer J Clin 2022; 72:454-489. [PMID: 35708940 DOI: 10.3322/caac.21729] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/28/2022] [Accepted: 04/11/2022] [Indexed: 12/23/2022] Open
Abstract
Brain metastases are a challenging manifestation of renal cell carcinoma. We have a limited understanding of brain metastasis tumor and immune biology, drivers of resistance to systemic treatment, and their overall poor prognosis. Current data support a multimodal treatment strategy with radiation treatment and/or surgery. Nonetheless, the optimal approach for the management of brain metastases from renal cell carcinoma remains unclear. To improve patient care, the authors sought to standardize practical management strategies. They performed an unstructured literature review and elaborated on the current management strategies through an international group of experts from different disciplines assembled via the network of the International Kidney Cancer Coalition. Experts from different disciplines were administered a survey to answer questions related to current challenges and unmet patient needs. On the basis of the integrated approach of literature review and survey study results, the authors built algorithms for the management of single and multiple brain metastases in patients with renal cell carcinoma. The literature review, consensus statements, and algorithms presented in this report can serve as a framework guiding treatment decisions for patients. CA Cancer J Clin. 2022;72:454-489.
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Affiliation(s)
- Elshad Hasanov
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Debra Nana Yeboa
- Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mathew D Tucker
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Todd A Swanson
- Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Thomas Hendrix Beckham
- Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Brian Rini
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Chibawanye I Ene
- Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Merve Hasanov
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sophie Derks
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Shaan Dudani
- Division of Oncology/Hematology, William Osler Health System, Brampton, Ontario, Canada
| | - Daniel Y C Heng
- Tom Baker Cancer Center, University of Calgary, Calgary, Alberta, Canada
| | - Priscilla K Brastianos
- Division of Neuro-Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Axel Bex
- The Royal Free London National Health Service Foundation Trust, London, United Kingdom
- University College London Division of Surgery and Interventional Science, London, United Kingdom
- Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Sahin Hanalioglu
- Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Jeffrey S Weinberg
- Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Laure Hirsch
- Department of Medical Oncology, Cochin University Hospital, Public Assistance Hospital of Paris, Paris, France
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Maria I Carlo
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ayal Aizer
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Paul David Brown
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Mehmet Asim Bilen
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia
- Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Eric Lin Chang
- Department of Radiation Oncology, University of Southern California, Keck School of Medicine, California, Los Angeles
| | - Jerry Jaboin
- Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon
| | - James Brugarolas
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, Texas
- Division of Hematology/Oncology, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Toni K Choueiri
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Michael B Atkins
- Lombardi Comprehensive Cancer Center, MedStar Georgetown University Hospital, Washington, DC
| | - Bradley A McGregor
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Lia M Halasz
- Department of Radiation Oncology, University of Washington, Seattle, Washington
| | - Toral R Patel
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Neurosurgery, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Scott G Soltys
- Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California
| | - David F McDermott
- Division of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - James Bradley Elder
- Department of Neurological Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Mustafa K Baskaya
- Department of Neurological Surgery, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin
| | - James B Yu
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Robert Timmerman
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Michelle Miran Kim
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Melike Mut
- Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - James Markert
- Department of Neurosurgery, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Kathryn Beal
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nizar M Tannir
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - George Samandouras
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
- University College London Queen Square Institute of Neurology, University College London, Queen Square, London, United Kingdom
| | - Frederick F Lang
- Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Rachel Giles
- International Kidney Cancer Coalition, Duivendrecht, the Netherlands
| | - Eric Jonasch
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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