ESTRO 2023 Young Track Report
“ESTRO-RANZCR: Role of radiotherapy in renal cell carcinoma: from the primary to the metastatic setting” – Clinical
The final day of ESTRO 2023 saw a continuation of high-level talks. A standout session was delivered by Dr Shankar Siva, Dr Ciro Franzese and Dr Stephanie Kroeze on the evolving role of radiotherapy in the treatment of both primary and metastatic renal cell carcinoma (RCC), a tumour type for which historically, radiotherapy has been regarded as of limited use as a treatment method.
This session started with Dr Siva talking about the role of stereotactic ablative body radiotherapy (SABR) in the treatment of the primary disease site. He covered a number of topics, from the radiobiology of the disease, with evidence of how RCCs are not radioresistant in the SABR setting, through the outcome data for patients who have received SABR to primary RCC, to the impacts on patients’ renal function after this treatment. He also looked ahead to the treatment of more locally advanced RCCs with SABR and where we might expect this treatment to go in the future. This talk firmly established the role of primary renal SABR amongst other established local treatments as an effective non-invasive treatment for this often frail patient population.
Dr Franzese followed on from this by expanding on the role that SABR has in the treatment of oligometastatic RCC. He looked at the role of SABR for both oligometastatic and oligoprogressive RCCs and gave an overview of the combination of this treatment with tyrosine-kinase inhibitors and what we might expect from this treatment. This talk established the role of SABR as part of the standard-of-care of systemic treatments and the impact this can have on overall patient survival, while having a minimal impact on the quality of patients’ lives.
This led nicely into the final talk of the session, which was focused specifically on the role of SABR in conjunction with immunotherapy for RCCs. Dr Kroeze began by laying a foundation of which patients were considered suitable to receive immunotherapy treatment and its baseline effectiveness, before showing how this treatment could be augmented by the addition of SABR. The effect of SABR on the primary site in a cyto-reductive setting was explored along with its role in the oligometastatic setting. The exciting prospects for this combination of treatments were hinted at in the discussion of the various clinical trials that are now collating data on the different ways in which it can be explored.
James Barber
Radiation therapist
Royal Free London NHS Foundation Trust
London, UK