ArticleThe oncologist2015
Algorithms in the First-Line Treatment of Metastatic Clear Cell Renal Cell Carcinoma--Analysis Using Diagnostic Nodes.
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Article in The oncologist, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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15citing papers in PubMed, 2 pooled it
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Surgical management of urolithiasis - a systematic analysis of available guidelines.BMC urology · 2018Pooled it
- Immunotherapy for metastatic renal cell carcinoma.The Cochrane database of systematic reviews · 2017Pooled it
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- Variations in Radioiodine Therapy in Europe: Decision-Making after Total Thyroidectomy.Oncology · 2022Article
- First-line treatment of metastatic clear cell renal cell carcinoma: a decision-making analysis among experts.ESMO open · 2021Article
- Variations in radioiodine ablation: decision-making after total thyroidectomy.European journal of nuclear medicine and molecular imaging · 2020Article
- Patterns of care in metastatic pancreatic cancer: patient selection in clinical routine.Therapeutic advances in gastroenterology · 2019Article
- Pre- and Postoperative Chemotherapy in Localized Extremity Soft Tissue Sarcoma: A European Organization for Research and Treatment of Cancer Expert Survey.The oncologist · 2018Review
- Applied Swarm-based medicine: collecting decision trees for patterns of algorithms analysis.BMC medical research methodology · 2017Article
- A Three-Variable Model Predicts Short Survival in Patients With Newly Diagnosed Metastatic Renal Cell Carcinoma.Journal of clinical medicine research · 2017Article
- Second-line treatment for metastatic clear cell renal cell cancer: experts' consensus algorithms.World journal of urology · 2017Article
- Pazopanib in Patients with Clear-Cell Renal Cell Carcinoma: Seeking the Right Patient.Frontiers in pharmacology · 2017Article
- Primary Tumor Characteristics Are Important Prognostic Factors for Sorafenib-Treated Patients with Metastatic Renal Cell Carcinoma: A Retrospective Multicenter Study.BioMed research international · 2017Article
- Sequential Therapy in Metastatic Renal Cell Carcinoma.Journal of kidney cancer and VHL · 2016Review
- Patterns of care in recurrent glioblastoma in Switzerland: a multicentre national approach based on diagnostic nodes.Journal of neuro-oncology · 2016Article
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Authors and funding
15 authors at 10 institutions in 7 countries.
Christian RothermundtDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland christian.rothermundt@kssg.ch.
Alexandra BaileyDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Linda CerboneDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Tim EisenDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Bernard EscudierDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Silke GillessenDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Viktor GrünwaldDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
James LarkinDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
David McDermottDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Jan OldenburgDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Camillo PortaDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Brian RiniDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Manuela SchmidingerDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Cora SternbergDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Paul M PutoraDivision of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy; Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, United Kingdom; Gustave Roussy, Villejuif, France; Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany; The Royal Marsden Hospital, London, United Kingdom; Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway; Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy; Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio, USA; Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken, Wien, Austria; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Kantonsspital St. Gallen · CHBeth Israel Deaconess Medical Center · USCarlo Forlanini Hospital · ITAkershus University Hospital · NOCleveland Clinic · USInstitut Gustave Roussy · FRMedizinische Hochschule Hannover · DENational Health Service · GBPoliclinico San Matteo Fondazione · ITRoyal Marsden Hospital · GB
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWith the advent of targeted therapies, many treatment options in the first-line setting of metastatic clear cell renal cell carcinoma (mccRCC) have emerged. Guidelines and randomized trial reports usually do not elucidate the decision criteria for the different treatment options. In order to extract the decision criteria for the optimal therapy for patients, we performed an analysis of treatment algorithms from experts in the field. MATERIALS AND
methodsTreatment algorithms for the treatment of mccRCC from experts of 11 institutions were obtained, and decision trees were deduced. Treatment options were identified and a list of unified decision criteria determined. The final decision trees were analyzed with a methodology based on diagnostic nodes, which allows for an automated cross-comparison of decision trees. The most common treatment recommendations were determined, and areas of discordance were identified.
resultsThe analysis revealed heterogeneity in most clinical scenarios. The recommendations selected for first-line treatment of mccRCC included sunitinib, pazopanib, temsirolimus, interferon-α combined with bevacizumab, high-dose interleukin-2, sorafenib, axitinib, everolimus, and best supportive care. The criteria relevant for treatment decisions were performance status, Memorial Sloan Kettering Cancer Center risk group, only or mainly lung metastases, cardiac insufficiency, hepatic insufficiency, age, and "zugzwang" (composite of multiple, related criteria).
conclusionIn the present study, we used diagnostic nodes to compare treatment algorithms in the first-line treatment of mccRCC. The results illustrate the heterogeneity of the decision criteria and treatment strategies for mccRCC and how available data are interpreted and implemented differently among experts. IMPLICATIONS FOR PRACTICE: The data provided in the present report should not be considered to serve as treatment recommendations for the management of treatment-naïve patients with multiple metastases from metastatic clear cell renal cell carcinoma outside a clinical trial; however, the data highlight the different treatment options and the criteria used to select them. The diversity in decision making and how results from phase III trials can be interpreted and implemented differently in daily practice are demonstrated.
Indexed as
AlgorithmsAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Renal CellDecision TreesDiagnosis, Computer-AssistedHumansKidney NeoplasmsNeoplasm MetastasisAlgorithmDecision criteriaRenal cell carcinomaTreatment
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