Over the last 20 years, the number of Americans with kidney cancer has risen every year. The most common type of kidney cancer is RCC (Renal Cell Carcinoma). It generally affects people between the ages 50 to 70 and it is a fatal disease. In this interview, Dr. Saby George and Dena Battle join Health Professional Radio to talk about a newly FDA approved treatment for renal cell carcinoma (RCC).
Saby George, M.D., FACP is an associate professor of oncology at Roswell Park Comprehensive Cancer Center, specializing in the treatment of kidney, bladder and prostate cancers. He is an investigator on Opdivo® (nivolumab) and Yervoy® (ipilimumab) clinical trials and has provided consulting services for Bristol-Myers Squibb.
Ms. Dena Battle is the President for KCCure. After losing her husband to kidney cancer, she remained active as a patient advocate and launched KCCure to increase research funding for the disease. KCCure’s patient education programs have been, in part, funded through grants from Bristol-Myers Squibb.
Neal Howard: Welcome to the program. I’m your host, Neal Howard here on Health Professional Radio. Over the last 20 years or so, the number of Americans with kidney cancer has risen every year. Now, the most common type of kidney cancer is RCC and it generally affects people between the ages of 50 and 70. Our guests today are Dr. Saby George an Associate Professor of Oncology at Roswell Park Comprehensive Cancer Center and joined with Dena Battle. She’s a president of the Kidney Cancer Research Alliance and they’re both joining us here to talk about a newly FDA-approved treatment for RCC. Welcome to the program both Dr. George and Dena. How are you both doing today?
Dena Battle: Doing very well. Thanks for having us.
Dr. Saby George: Thank you for having us.
N: Great. Dr. George, what is RCC?
S: RCC Renal Cell Carcinoma is the common type of cancer that occurs in the kidney, accounts for nearly 90% of cancer in the kidney and it’s a fatal disease that affects nearly 63,000 patients in the US every year and it’s a male predominant disease which occurs mostly in patients of the age between 50 and 70.
N: So I mentioned that every year the number of these people affected rises. Why is kidney cancer on the rise?
S: I don’t really know the reason why kidney cancer incidents is on the rise but that being said, there are certain factors which may lead to kidney cancer including smoking, hypertension, obesity, and exposure to certain chemicals. But there could be other causes which we don’t know which may be the reason why the kidney cancer incidents is on the rise. Although it’s a fatal disease, it results in nearly 15,000 or so that’s a year in the US.
N: So with renal cell carcinoma or RCC affecting as I said generally and as you agreed with people between the ages of 50 and 70, why is this age group affected more?
S: Again, I don’t know the exact reasons but we could hypothesize that possibly it has something to do with exposure over the years and it may take so many years for the exposure to result in cancer. Interestingly, kidney cancer is associated with 7 mutations and a vast majority of the kidney cancers associated with what’s called VHL mutation or methylation which is sporadic, which means patients pick it up on when before they developed cancer over the years. But we don’t know the exact reasons why that is the case either.
N: Well, with some of the new treatment options and one of which I’m sure we’re going to talk about, are they readily available to some of these people who are affected?
S: Yes. All of these treatment options are available and most of the vendors offer the newest treatments and today we’re particularly going to talk about a combination immunotherapy.
N: This combination, is it something that is brand new or something that has been in use and simply improved upon?
S: So the combination of Opdivo and Yervoy both are immuno-oncology agent for immunotherapy drugs. They were approved three to four weeks ago by FDA for the use in kidney cancer or advanced kidney cancer. So this was based on a large clinical trial named CheckMate-214 and I was a principal investigator at Walsall Park on this trial and I’m a paid consultant of VMS as well because of these trials that I do here. That trial demonstrated the combination of Opdivo and Yervoy was able to produce more tumor shrinkage in kidney cancer patients as well as made those patients live longer compared to the standard-of-care which was … named sunitinib (Sutent). So this was exciting results and also resulted in 9% of patients going to complete remission and the combination of. So that’s the reason why FDA approved this combination. It’s available at this time for patients.
N: So it’s only for use in the advanced stages of RCC. Is there anything that can be done when RCC is not in such an advanced stage using the same type or maybe a milder dose of this formulation?
S: Right. No. Advanced stage means advanced age for or in cure over surgery, locally advanced which cannot be treated with surgery or radiation. So advanced stage is basically fatal disease and so it is approved only for the use in advanced disease and also in a subset named intermediate and poorest patients with kidney cancer which is basically comprising the vast majority of advanced kidney cancer patients.
N: Dena, you’re the president of the Kidney Cancer Research Alliance or KCCure. What is KCCure and how did this organization get started?
D: KCCure is a grassroots organization of patients and doctors that came together to increase research funding for kidney cancer and also increase awareness and educational materials. I started KCCure after losing my husband to kidney cancer. And it’s kind of a special story because I joined together with Dr. Hans Hammers, who was the medical oncologist who treated my late husband. We saw a real need to increase research funding especially early-stage research funding for kidney cancer.
N: And as far as the early-stage funding, are there certain challenges that we see challenges with raising awareness and funding for certain rare diseases? But one that such as this, what challenges have you been able to overcome as a result of starting KCCure?
D: I always like to say that kidney cancer is just rare in us and just common enough. I’m in sort of in-between. And it’s really difficult to get funding because I mean we have 60,000 patients diagnosed each year the incidence number is still fairly small and getting access to funding especially for early research to develop new cures can be very challenging and difficult for doctors. So we launched a peer-reviewed research planned program to provide that level of funding.
N: So how do you get folks who are dealing and living with RCC both the patients and the caregivers connected with these resources that you provide?
D: So our website is kccure.org and we provide educational material as well as ways and methods that patients can connect with one another. I’m grateful to industry partners like Bristol-Myers Squibb that helped us and supported us to develop some of that material. Our website is kccure.org and patients can access them about material there. We also recommend that patients go to opdivo.com which is another website that’s a great resource that talks about this new combination therapy which is really exciting for patients and their families.
N: Dr. George in just a couple of minutes that we have left, what do you see on the horizon for future treatments of RCC based on these positive results in this newly FDA-approved treatment?
S: That’s a wonderful question. Basically, this new combination treatment demonstrates that it can put 9% of patients in complete remission and it can make people live a lot longer compared to the previously available drugs. So we are basically one step closer to a cure with this development and I see more and more combination trials and also the application of this combination, the most important combination available for kidney cancer patients today. Moving into earlier phases like in the near adjuvant and in the adjuvant setting meaning before surgery and after surgery with the curative intent, that is probably the only way to eliminate a disease from an early stage. But again, with the research and development ongoing and the effort of a lot of doctors like me all over the world, I hope we’ll get to cure in a higher percentage of patients and I put this behind us one day.
N: Well, I thank both of you for coming in and sharing with us today, Dr. Saby George, Associate Professor of Oncology at Roswell Park Comprehensive Cancer Center and Dena Battle, President of the Kidney Cancer Research Alliance. Dr. George, where can we learn some more about Roswell Park Comprehensive Cancer Center?
S: So we have a few websites. Also, roswellpark.org is a website where it gives you all the links to the resources available and also the clinical trials available at the institute. And of course, we are an NCCN, National Comprehensive Cancer Center, one of the big cancer centers. There are a lot of other centers in the US and so we get patients from all over and they can go to our website look at the clinical trials available and look at doctors by the specialty, etc. And that’s easy as that and you can take it from there.
N: Well, I thank you both for coming in again and I’m hoping to talk with you again in the future.
S and D:Thanks very much for having us.
N: You’ve been listening to Health Professional Radio. I’m your host, Neal Howard. Transcripts and audio of this program are available at hpr.fm and you can subscribe to the podcast on iTunes listen in and download at SoundCloud and visit our affiliates page at hpr.fm.