Personalized treatment of kidney cancer patients can increase survival, according to a UCLA study of almost 1,500 patients that identified subsets of kidney cancer that behave differently and need to be treated accordingly.
The UCLA team said their findings indicate the traditional one-size-fits-all treatment approach needs to be changed.
"We have shown that not all kidney cancer patients are the same, not all localized kidney cancers are the same, and not all metastatic kidney cancers are the same," study senior author Dr. Arie Belldegrun, a professor of urology and a researcher at UCLA's Jonsson Comprehensive Cancer Center, said in a UCLA news release.
Patients with localized kidney cancer can have either low-, intermediate-, or high-risk cancers based on the chance for recurrence, the researchers found. Patients with kidney cancer that's spread (metastatic cancer) can also be categorized into similar subsets.
"Now we can base treatment decisions based on that," Belldegrun said.
Patients with localized, low-risk kidney cancer have a projected five-year survival rate of 97 percent and a 10-year survival rate of 92 percent, compared to 81 percent and 61 percent for patients with localized, intermediate-risk cancer, and 62 percent and 41 percent for patients with localized, high-risk cancer.
"All these patients with cancers that have not spread present to their doctors with presumably localized disease, and in the past, they may have been treated the same way. They need to be treated individually, according to their risk levels," Belldegrun said.
For example, the UCLA team showed that surgery alone can produce excellent outcomes in patients with localized, low-risk, kidney cancer, meaning they could be spared the harsh side effects associated with radiation or immunotherapy. But surgery alone isn't sufficient for patients with localized, high-risk kidney cancer.
Patients with metastatic, low-risk cancer should get very aggressive treatment, because there's a good chance the therapy will benefit them. But patients with metastatic, high-risk cancer may choose to decline treatment, because they'll get little or no benefit from it.
"Our paper identifies, very precisely, which patients should get which therapies," Belldegrun said.
The study was published in the Nov. 1 issue of Cancer.
More information
The American Urological Association has more about kidney cancer.
SOURCE: University of California, Los Angeles, news release, Nov. 1, 2008
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