This activity is for healthcare professionals outside of the UK.

This activity is provided by an independent medical education grant from MSD.

The activity is jointly provided by USF Health and touchIME.

Faculty & Disclosures

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    Faculty & Disclosures
    Prof. Hans Hammers

    UT Southwestern, Dallas, TX, USA

    Prof. Hans Hammers is a professor in the Department of Internal Medicine at UT Southwestern Medical Center, Dallas, TX, USA, and a member of the Division of Hematology and Oncology. He is the inaugural Eugene P. Frenkel, M.D. Scholar in Clinical Medicine.read more

    Prof. Hammers is an internationally recognized leader in systemic therapy for the treatment of metastatic renal cell carcinoma, drug development and immunotherapy. He completed his training at Johns Hopkins Bayview Medical Center in Baltimore, MD, where he led the kidney cancer research efforts and made impactful contributions to immunotherapies for the treatment of kidney cancer.

    He was recruited to UT Southwestern to lead the clinical research efforts in kidney cancer. He is a founding member of the Clinical Trial Research Consortium for kidney cancer and is the principal investigator on multiple investigator-initiated and industry-sponsored clinical trials. In addition to his clinical research, he is developing novel therapeutic approaches for immunotherapy and angiogenesis inhibition.

    Prof. Hans Hammers discloses: Advisory board or panel fees from Aveo, Eisai and Merck. Grants/research support from AbbVie, Agenus, Aveo and Merck.
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    touchONCOLOGY touchONCOLOGY
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    Focus Questions
    What is the role of the MDT in assessing factors to guide treatment decision-making for patients with stage I, II or III RCC?
    How does the MDT decide whether a patient with early-stage RCC might benefit from adjuvant therapy – is there a role for prognostic and risk stratification models?
    What is the risk stratification and prognostication process for deciding, within the MDT, the optimal first-line treatment for patients with advanced/metastatic RCC, and how can the risk of overtreatment be addressed?
    What are the options for subsequent lines of treatment for patients with treatment refractory advanced/metastatic RCC and how are they decided within the MDT?
    What are the key ongoing clinical trials in patients with refractory RCC and how might these impact future clinical practice?
    What disparities in outcomes among RCC patient populations are present and which populations are affected most often? Why does inequity exist?
    What is shared decision-making and why is it important for addressing inequity? How does it help improve outcomes for underserved populations with RCC?
    What additional strategies do you use within your MDT to help address inequity in diverse and/or underserved populations?
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    Personalizing care within the MDT for patients with early through to advanced RCC

    Take CE/CME Test

    Prof. Hans Hammers is a professor in the Department of Internal Medicine at UT Southwestern Medical Center, Dallas, TX, USA, and a member of the Division of Hematology and Oncology. He is the inaugural Eugene P. Frenkel, M.D. Scholar in Clinical Medicine.read more

    Prof. Hammers is an internationally recognized leader in systemic therapy for the treatment of metastatic renal cell carcinoma, drug development and immunotherapy. He completed his training at Johns Hopkins Bayview Medical Center in Baltimore, MD, where he led the kidney cancer research efforts and made impactful contributions to immunotherapies for the treatment of kidney cancer.

    He was recruited to UT Southwestern to lead the clinical research efforts in kidney cancer. He is a founding member of the Clinical Trial Research Consortium for kidney cancer and is the principal investigator on multiple investigator-initiated and industry-sponsored clinical trials. In addition to his clinical research, he is developing novel therapeutic approaches for immunotherapy and angiogenesis inhibition.

    Prof. Hans Hammers discloses: Advisory board or panel fees from Aveo, Eisai and Merck. Grants/research support from AbbVie, Agenus, Aveo and Merck.

    Faculty Podcast Featured
    Learning Objectives

    After watching this activity, participants should be better able to:

    • Apply diagnostic and prognostic markers and clinical data within the MDT to personalize care for patients with early stage through advanced and metastatic renal cell carcinoma
    • Use effective communication strategies and encourage shared decision-making when managing diverse and/or underserved patients with renal cell carcinoma
    Overview

    In this interview, Prof. Hans Hammers answers a series of questions on the application of prognostic markers and clinical data within the MDT to personalize care for patients with early stage through to advanced and metastatic RCC. He goes on to highlight the use of effective communication strategies and shared decision-making when managing diverse and/or underserved populations with RCC.

    This activity is jointly provided by USF Health and touchIME.read more

    Target Audience

    This activity has been designed to meet the educational needs of oncologists, oncology nurses, pharmacists, radiologists and urologists involved in the management of patients with RCC.

    Disclosures

    USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

    Faculty

    Prof. Hans Hammers discloses: Advisory board or panel fees from Aveo, Eisai and Merck. Grants/research support from AbbVie, Agenus, Aveo and Merck.

    Content reviewer

    Danielle Walker, DNP, APRN, AGNP-C Nurse Reviewer and Planner has no financial interests/relationships or affiliations in relation to this activity.

    Touch Medical Contributors

    Sola Neunie has no financial interests/relationships or affiliations in relation to this activity.

    Rebecca Franklin discloses: Independent contractor relationship: Fishawack Communications (Relationship Terminated).

    USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

    Requirements for Successful Completion

    In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

    If you have questions regarding credit please contact cpdsupport@usf.edu 

    Accreditations

    Physicians

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

    USF Health designates this enduring material for a maximum of 0.5 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu).

    Advanced Practice Providers

    Physician Assistants may claim a maximum of 0.5 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

    The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

    Nurses

    USF Health is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

    A maximum of 0.5 contact hours may be earned by learners who successfully complete this continuing professional development activity. USF Health, the accredited provider, acknowledges touchIME as the joint provider in the planning and execution of this CNE activity.

    This activity is awarded 0.5 ANCC pharmacotherapeutic contact hour.

    Pharmacists

    USF Health is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This knowledge-based program has been approved for 0.5 contact hours (0.5 CEUs).  Universal program number is as follows: (UAN number 0230-9999-24-007-H01-P).

    Date of original release: 19 August 2024. Date credits expire: 19 August 2025.

    If you have any questions regarding credit, please contact cpdsupport@usf.edu

    This activity is CE/CME accredited

    To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

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    Topics covered in this activity

    Renal Cancer / Genitourinary Cancer / Immunotherapy
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    This Activity Is Funded By:

    An independent medical education grant from MSD.
    This activity is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    This content is intended for healthcare professionals outside the UK only.

    Date of original release: 19 August 2024. Date credits expire: 19 August 2025.

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    Personalizing care within the MDT for patients with early through to advanced RCC
    0.5 CE/CME credit
    Question 1/3
    You have a 48-year-old patient with asymptomatic, low-volume, stage IV clear cell RCC, a favourable risk profile and good performance status. After carrying out a risk assessment, and assuming all options are available, which of the following would you recommend as first-line treatment during the multidisciplinary team meeting?

    CTLA-4, cytotoxic T-lymphocyte associated protein 4; PD-1, programmed cell death protein 1; RCC, renal cell carcinoma; VEGFR TKI, vascular endothelial growth factor receptor tyrosine kinase inhibitor.

    Combined PD-1 inhibitor + VEGFR TKI or PD-1 inhibitor + CTLA-4 inhibitor are standard of care options for patients with advanced clear cell RCC of any risk category.1,2 While cross-trial comparisons should be interpreted with caution, studies have demonstrated a greater response rate with ICI–TKI combinations vs the dual ICI combination (56–71% vs 39%) but longer durations of response with the dual ICI combination than the ICI–TKI combinations (not reached at 67.7 months vs 20–26 months).3 The dual ICI combination may be considered for select favourable-risk patients with low-volume disease and the goal of long-term durable efficacy;4 whereas an ICI–TKI combination may be reserved for patients with high tumour burden or aggressive disease that requires urgent disease control.3 Preferred first-line approaches for advanced RCC have shifted from TKI monotherapy to combination strategies for most patients.3

    Abbreviations

    CTLA-4, cytotoxic T-lymphocyte associated protein 4; ICI, immune checkpoint inhibitor; PD-1, programmed cell death protein 1; RCC, renal cell carcinoma; TKI, tyrosine kinase inhibitor; VEGFR, vascular endothelial growth factor receptor.

    References

    1. NCCN Guidelines®. Kidney Cancer Version 1.2025 — July 1, 2024. Available at: NCCN.org (accessed 10 July 2024).
    2. Powles T, et al. Ann Oncol. 2024;35:692–706. 
    3. Lalani AA, et al. Ther Adv Med Oncol. 2022;14:17588359221108685.
    4. Chen YW, et al. Curr Treat Options Oncol. 2023;24:1889–916.
    Question 2/3
    What strategy might help to encourage patients with RCC from underserved, including minority, populations to consider enrolling in a clinical trial?

    RCC, renal cell carcinoma.

    There is limited diversity, inclusion and equity in cancer clinical trials, yet given the rapid pace of their conduct and the resulting regulatory approvals and changes in treatment practice, diverse participant recruitment is crucial.1 Clear disparities in access and participation in clinical trials are present.1 Minority groups experience greater barriers to clinical trial participation, such as lower income and lack of transportation to visits.1 Strategies to improve minority enrolment in cancer clinical trials include ride-share services and reimbursed travel, improved patient education and informed consent processes, as well as outreach programmes and culturally sensitive strategies.1,2

    References

    1. Pain D, et al. Kidney Cancer. 2022;6:147–57.
    2. Guerra CE, et al. J Clin Oncol. 2021;39(Suppl.15):100
    Question 3/3
    A community oncologist has contacted you for advice regarding treatment for a patient with metachronous oligometastatic RCC who underwent resection 6 years prior. Living in a rural location with limited transportation, the patient is part of the underserved RCC population. Which of the following would you recommend that they discuss with the patient regarding next steps?

    ICI, immune checkpoint inhibitor; RCC, renal cell carcinoma; TKI, tyrosine kinase inhibitor.

    While systemic treatments may be justified in patients with aggressive disease, poor risk status or widely metastatic disease, they are associated with high rates of grade ≥3 toxicities that may impact quality of life,1,2 require regular clinic visits for treatment administration3 and may not be necessary for all patients with metastatic disease.2 Several studies have demonstrated that patients with oligometastatic RCC may benefit from stereotactic ablative radiotherapy, a noninvasive option that can provide good local control,2,4 treat multiple metastases simultaneously,2 requires no recovery2 and allows systemic therapy to be delayed without impacting survival or duration of subsequent lines of treatment.1,2 Therefore, although other options are valid for this patient, stereotactic ablative radiotherapy is preferred.4

    Abbreviation

    RCC, renal cell carcinoma.

    References

    1. Beecroft N, et al. J Kidney Cancer VHL. 2024;11:27–38.
    2. Mohamad O, et al. ASCO Daily News. 2024. Available at: https://bit.ly/3LDLXxz (accessed 10 July 2024).
    3. FDA. Pembrolizumab PI. Available at: https://bit.ly/4d52xSE (accessed 17 July 2024).
    4. Dason S, et al. Am Soc Clin Oncol Educ Book. 2023;43:e390038.
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    This Activity Is Funded By:

    An independent medical education grant from MSD.
    This activity is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    This content is intended for healthcare professionals outside the UK only.

    Date of original release: 19 August 2024. Date credits expire: 19 August 2025.

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