2024
72 Impact of microbiome modulation on serum cytokine profile in a randomized, phase I trial of cabozantinib/nivolumab (cabo/nivo) with or without CBM588 in pts with metastatic renal cell carcinoma (mRCC)
Li Y, Ebrahimi H, Meza L, Malhotra J, Li X, Dizman N, Dorff T, Frankel P, Llamas-Quitiquit M, Hsu J, Zengin Z, Alcantara M, Castro D, Mercier B, Chawla N, Chehrazi-Raffle A, Barragan-Carrillo R, Gillece J, Trent J, Lee P, Parks T, Takahashi M, Hayashi A, Caporaso J, Lee K, Tripathi A, Pal S. 72 Impact of microbiome modulation on serum cytokine profile in a randomized, phase I trial of cabozantinib/nivolumab (cabo/nivo) with or without CBM588 in pts with metastatic renal cell carcinoma (mRCC). The Oncologist 2024, 29: s36-s37. PMCID: PMC11301871, DOI: 10.1093/oncolo/oyae181.059.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaSerum cytokine profilesCytokine profileClinical outcomesCD8-positive subsetGranulocyte-macrophage colony stimulating factorLevels of IL-12Poor-risk diseasePhase I trialRenal cell carcinomaCirculating cytokine levelsWilcoxon matched-pairs testLevels of cytokinesColony stimulating factorFlow cytometric analysisMatched-pairs testSarcomatoid histologySarcomatoid featuresSystemic immunomodulationCell carcinomaI trialClear cellCytokine levelsInterferon-gIL-13Cabozantinib and nivolumab with or without live bacterial supplementation in metastatic renal cell carcinoma: a randomized phase 1 trial
Ebrahimi H, Dizman N, Meza L, Malhotra J, Li X, Dorff T, Frankel P, Llamas-Quitiquit M, Hsu J, Zengin Z, Alcantara M, Castro D, Mercier B, Chawla N, Chehrazi-Raffle A, Barragan-Carrillo R, Jaime-Casas S, Govindarajan A, Gillece J, Trent J, Lee P, Parks T, Takahashi M, Hayashi A, Kortylewski M, Caporaso J, Lee K, Tripathi A, Pal S. Cabozantinib and nivolumab with or without live bacterial supplementation in metastatic renal cell carcinoma: a randomized phase 1 trial. Nature Medicine 2024, 30: 2576-2585. PMID: 38942995, PMCID: PMC11405272, DOI: 10.1038/s41591-024-03086-4.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaProgression-free survivalRenal cell carcinomaCell carcinomaToxicity profileAbundance of Bifidobacterium sppControl armTreatment-naive participantsFirst-line treatmentPhase 1 studyPhase 1 trialSarcomatoid componentOpen-labelHistological confirmationPrimary endpointSecondary endpointsNo significant differenceClear cellNivolumabInvestigator-initiatedClinical outcomesCabozantinibClinical activityStool samplesStudy armsPrevalence of Dietary Modification and Supplement Use in Patients with Metastatic Renal Cell Carcinoma Receiving Systemic Therapy
Ebrahimi H, Battle D, Salgia N, Zengin Z, Dizman N, Meza L, Bergerot C, Barragan-Carrillo R, Hsu J, Castro D, Mercier B, Chawla N, Li X, Tripathi A, Liu S, Chehrazi-Raffle A, Vaishampayan U, Staehler M, Pal S. Prevalence of Dietary Modification and Supplement Use in Patients with Metastatic Renal Cell Carcinoma Receiving Systemic Therapy. Nutrients 2024, 16: 1630. PMID: 38892563, PMCID: PMC11174627, DOI: 10.3390/nu16111630.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaRenal cell carcinomaCell carcinomaDietary modificationSupplement useDiagnosis of renal cell carcinomaFirst-line treatmentSupplement usageSystemic therapyCombination therapyAntineoplastic therapyKetogenic dietCarcinomaCancer therapyMediterranean dietPhysician-patient dialoguePatientsTherapyCancer treatmentGrowing body of evidenceBody of evidenceDietary changesCancerCancer diagnosisCannabidiolImpact of Synchronous versus Metachronous Metastasis on Outcomes in Patients with Metastatic Renal Cell Carcinoma Treated with First-line Immune Checkpoint Inhibitor–based Combinations
Gebrael G, Meza L, Li X, Zengin Z, Sayegh N, Ebrahimi H, Tripathi N, Castro D, Mercier B, Barragan-Carrillo R, Li H, Chehrazi-Raffle A, Swami U, Tripathi A, Agarwal N, Maughan B, Pal S. Impact of Synchronous versus Metachronous Metastasis on Outcomes in Patients with Metastatic Renal Cell Carcinoma Treated with First-line Immune Checkpoint Inhibitor–based Combinations. European Urology Focus 2024 PMID: 38580524, DOI: 10.1016/j.euf.2024.03.006.Peer-Reviewed Original ResearchTime to treatment failureDisease control rateRenal cell carcinomaSynchronous metastasesMetachronous metastasesOverall survivalMetachronous metastatic renal cell carcinomaMedian time to treatment failureICI-based combination therapyAssociated with worse OSMetastatic renal cell carcinomaFirst-line immunotherapyICI-based combinationsRenal cell carcinoma diagnosisDiagnosis of kidney cancerHypothesis-generating studyMedian OSMetachronous groupPoor OSTreatment failureCombination therapyMetastasis onsetCell carcinomaSurvival outcomesClinical outcomesCD70-Targeted Allogeneic CAR T-Cell Therapy for Advanced Clear Cell Renal Cell Carcinoma
Pal S, Tran B, Haanen J, Hurwitz M, Sacher A, Tannir N, Budde L, Harrison S, Klobuch S, Patel S, Meza L, Dequeant M, Ma A, He Q, Williams L, Keegan A, Gurary E, Dar H, Karnik S, Guo C, Heath H, Yuen R, Morrow P, Agarwal N, Srour S. CD70-Targeted Allogeneic CAR T-Cell Therapy for Advanced Clear Cell Renal Cell Carcinoma. Cancer Discovery 2024, 14: of1-of14. PMID: 38583184, PMCID: PMC11215406, DOI: 10.1158/2159-8290.cd-24-0102.Peer-Reviewed Original ResearchClear cell renal cell carcinomaChimeric antigen receptorCAR-T cellsT-cell therapyCell renal cell carcinomaRenal cell carcinomaT cellsCell carcinomaSolid tumorsAllogeneic CAR-T cell therapyChimeric antigen receptor T cellsAdvanced clear cell renal cell carcinomaAllogeneic CAR-T cellsClinical trialsCAR-T cell productsCAR-T cell therapyTreatment of solid tumorsFirst-in-human clinical trialCAR-T constructsDose-limiting toxicityT cell productionNovel treatment optionsTreatment of clear cell renal cell carcinomaHematologic malignanciesAntigen receptorAssociation between thymectomy and incidence of renal cell carcinoma (RCC).
Barragan-Carrillo R, Ebrahimi H, Chawla N, Salgia N, Castro D, Chehrazi-Raffle A, Dizman N, Hsu J, Meza L, Zengin Z, LeVee A, Tripathi A, Dorff T, Bergerot C, Bergerot P, Eilber K, Dallas K, Pal S. Association between thymectomy and incidence of renal cell carcinoma (RCC). Journal Of Clinical Oncology 2024, 42: 371-371. DOI: 10.1200/jco.2024.42.4_suppl.371.Peer-Reviewed Original ResearchRenal cell carcinomaIncidence of nephrectomyIncidence of renal cell carcinomaMedian age of patientsFrequency of nephrectomyAge of patientsT cell productionProportion of patientsRate of nephrectomyFisher's exact testGeneral populationAge-matched populationICD-9/10 codesPopulation-based cohortPopulation-based studyImmunogenic cancerPrior thymectomyChi-square testCell carcinomaMedian ageSurgical interventionNephrectomyThymectomyExact testOSHPD databaseClinical and molecular characterization of urothelial (UC) vs. small cell carcinoma (SCC) of the urinary tract.
Chawla N, Mercier B, Govindarajan A, Li X, Castro D, Ebrahimi H, Barragan-Carrillo R, Zang P, LeVee A, Dizman N, Hsu J, Meza L, Zengin Z, Salgia N, Chehrazi-Raffle A, Dorff T, Pal S, Tripathi A. Clinical and molecular characterization of urothelial (UC) vs. small cell carcinoma (SCC) of the urinary tract. Journal Of Clinical Oncology 2024, 42: 682-682. DOI: 10.1200/jco.2024.42.4_suppl.682.Peer-Reviewed Original ResearchSmall cell carcinomaFeatures of small cell carcinomaGenome sequencePrevalence of genomic alterationsSmall cell carcinoma patientsSmall cell carcinoma groupFrequency of CDKN2APrevalence of TP53Fisher's exact testTumor gradeCell carcinomaPathological variablesUse of bloodUrinary tractBladder cancerExact testGenomic alterationsProportion Z testGenomic profilingGenomic featuresPathological featuresTherapeutic strategiesGenomic datasetsGenomic characteristicsBonferroni correctionOutcomes of Patients with Brain Metastases from Renal Cell Carcinoma Receiving First-line Therapies: Results from the International Metastatic Renal Cell Carcinoma Database Consortium
Takemura K, Lemelin A, Ernst M, Wells J, Saliby R, El Zarif T, Labaki C, Basappa N, Szabados B, Powles T, Davis I, Wood L, Lalani A, McKay R, Lee J, Meza L, Pal S, Donskov F, Yuasa T, Beuselinck B, Gebrael G, Agarwal N, Choueiri T, Heng D. Outcomes of Patients with Brain Metastases from Renal Cell Carcinoma Receiving First-line Therapies: Results from the International Metastatic Renal Cell Carcinoma Database Consortium. European Urology 2024 PMID: 38290965, DOI: 10.1016/j.eururo.2024.01.006.Peer-Reviewed Original ResearchInternational Metastatic Renal Cell Carcinoma Database ConsortiumBrain metastasesRenal cell carcinomaStereotactic radiotherapyOverall survivalSystemic therapyCell carcinomaAssociated with longer median overall survivalAssociated with longer overall survivalInitiation of systemic therapyLonger median overall survivalAssociated with longer OSTyrosine kinase inhibitor monotherapyAssociated with better prognosisIO-based regimensMedian overall survivalWhole-brain radiotherapyFirst-line therapyAdvanced kidney cancerLonger overall survivalOutcomes of patientsGroup of patientsCombination immunotherapyLonger OSInhibitor monotherapy
2023
Genomic and Transcriptomic Characteristics of Tumors of Patients with Metastatic Clear Cell Renal Cell Carcinoma Clinically Benefiting from First-Line Treatment with Ipilimumab Plus Nivolumab
Tripathi N, Meza L, Sayegh N, Govindarajan A, Byron S, Zhang J, Chigarira B, Jo Y, Zengin Z, Li H, Gebrael G, Desai A, Agarwal N, Swami U, Maughan B, Pal S. Genomic and Transcriptomic Characteristics of Tumors of Patients with Metastatic Clear Cell Renal Cell Carcinoma Clinically Benefiting from First-Line Treatment with Ipilimumab Plus Nivolumab. Kidney Cancer 2023, 7: 137-145. DOI: 10.3233/kca-230011.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaClear cell metastatic renal cell carcinomaClinical benefit groupRenal cell carcinomaClinical benefitNivolumab therapyCell carcinomaPoor-risk metastatic renal cell carcinomaMetastatic clear cell renal cell carcinomaBenefit groupClear cell renal cell carcinomaFirst-line ipilimumabIMDC risk scoresFirst-line treatmentCell renal cell carcinomaAlteration frequencyChi-square testMRCC patientsStable diseaseComplete responsePartial responseSystemic therapyLine treatmentInflammatory pathwaysTumor-specific gene expressionCharacterization of Patients with Metastatic Renal Cell Carcinoma Undergoing Deferred, Upfront, or No Cytoreductive Nephrectomy in the Era of Combination Immunotherapy: Results from the International Metastatic Renal Cell Carcinoma Database Consortium
Takemura K, Ernst M, Navani V, Wells J, Bakouny Z, Donskov F, Basappa N, Wood L, Meza L, Pal S, Szabados B, Powles T, Beuselinck B, McKay R, Lee J, Ernst D, Kapoor A, Yuasa T, Choueiri T, Heng D. Characterization of Patients with Metastatic Renal Cell Carcinoma Undergoing Deferred, Upfront, or No Cytoreductive Nephrectomy in the Era of Combination Immunotherapy: Results from the International Metastatic Renal Cell Carcinoma Database Consortium. European Urology Oncology 2023, 7: 501-508. PMID: 37914579, DOI: 10.1016/j.euo.2023.10.002.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaInternational mRCC Database ConsortiumCytoreductive nephrectomySystemic therapy initiationMetastatic kidney cancerRenal cell carcinomaCombination immunotherapyDeferred CNUpfront CNCN statusPrimary tumorOverall survivalTherapy initiationCell carcinomaInternational Metastatic Renal Cell Carcinoma Database ConsortiumAdvent of novel therapeutic agentsKidney cancerInitiation of systemic therapyDiagnosis of metastatic diseaseTreatment of choiceProportion of patientsCox proportional-hazards regressionCharacterization of patientsIO-based combinationsProportional-hazards regression1902P Comparison of cabozantinib (CABO) versus sunitinib (SUN) following first-line (1L) nivolumab plus ipilimumab (NIVO+IPI) for metastatic renal cell carcinoma (mRCC): A target trial emulation using real-world data from the International mRCC Database Consortium (IMDC)
Lemelin A, Takemura K, Boyne D, Warkentin M, Brenner D, Cheun W, Wells J, Labaki C, McGregor B, Basappa N, Meza L, Pal S, Beuselinck B, McKay R, Szabados B, Powles T, Yuasa T, Ludwig L, Choueiri T, Heng D. 1902P Comparison of cabozantinib (CABO) versus sunitinib (SUN) following first-line (1L) nivolumab plus ipilimumab (NIVO+IPI) for metastatic renal cell carcinoma (mRCC): A target trial emulation using real-world data from the International mRCC Database Consortium (IMDC). Annals Of Oncology 2023, 34: s1023-s1024. DOI: 10.1016/j.annonc.2023.09.1132.Peer-Reviewed Original Research1893P Immune-related adverse events from contemporary first-line combination therapies in metastatic renal cell carcinoma: Results from the IMDC
Navani V, Lemelin A, Powles T, Liow E, Wong S, Meza L, Ebrahimi H, Saliby R, Saad E, Yuasa T, Wood L, Kollmannsberger C, Graham J, North S, Basappa N, Donskov F, Rodriguez C, Lalani A, Choueiri T, Heng D. 1893P Immune-related adverse events from contemporary first-line combination therapies in metastatic renal cell carcinoma: Results from the IMDC. Annals Of Oncology 2023, 34: s1018-s1019. DOI: 10.1016/j.annonc.2023.09.1123.Peer-Reviewed Original ResearchCharacterization of papillary and clear cell renal cell carcinoma through imaging mass cytometry reveals distinct immunologic profiles
Govindarajan A, Salgia N, Li H, Castro D, Mirzapoiazova T, Armstrong B, Zhao D, Mercier B, Dizman N, Chawla N, Zengin Z, Meza L, Tripathi N, Sayegh N, Chehrazi-Raffle A, Tripathi A, Pal S. Characterization of papillary and clear cell renal cell carcinoma through imaging mass cytometry reveals distinct immunologic profiles. Frontiers In Immunology 2023, 14: 1182581. PMID: 37638025, PMCID: PMC10457014, DOI: 10.3389/fimmu.2023.1182581.Peer-Reviewed Original ResearchConceptsClear cell renal cell carcinomaPapillary renal cell carcinomaRenal cell carcinomaCell renal cell carcinomaCell carcinomaT cellsTumor microenvironmentPRCC cohortCcRCC cohortCcRCC patientsMain immune cell typesDistinct immunologic profileRCC histological subtypesMedian overall survivalProportion of CD4Baseline tumor tissueImmune cell populationsSubtypes of RCCImmune cell typesMass cytometry analysisCross-validate findingsSignificant differencesFFPE samplesMacrophage compositionTME compartmentsAssociation Between Time-of-Day of Immune Checkpoint Blockade Administration and Outcomes in Metastatic Renal Cell Carcinoma
Dizman N, Govindarajan A, Zengin Z, Meza L, Tripathi N, Sayegh N, Castro D, Chan E, Lee K, Prajapati S, Feng M, Loo V, Pace M, O'Brien S, Bailey E, Barragan-Carrillo R, Chehrazi-Raffle A, Hsu J, Li X, Agarwal N, Pal S. Association Between Time-of-Day of Immune Checkpoint Blockade Administration and Outcomes in Metastatic Renal Cell Carcinoma. Clinical Genitourinary Cancer 2023, 21: 530-536. PMID: 37495481, DOI: 10.1016/j.clgc.2023.06.004.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaObjective response rateTreatment failureRenal cell carcinomaHazard ratioOverall survivalCell carcinomaMultivariate analysisHigh Cut-OffNivolumab/ipilimumabProspective Randomized StudyBaseline characteristicsRandomized studyClinical outcomesMedian timePreclinical evidenceUnivariate analysisPatientsResponse rateImmune systemInfusion timeStatistical significanceOutcomesCarcinomaInfusionAssessment of short-chain fatty acid (SCFA) and circulating cytokine trends in a clinical trial of nivolumab/ipilimumab and CBM588 in metastatic renal cell carcinoma (mRCC).
Dizman N, Pathak K, Alcantara M, Meza L, Bergerot P, Willey M, Dorff T, Hsu J, Zengin Z, Castro D, Ebrahimi H, Chehrazi-Raffle A, Tripathi A, Trent J, Takahashi M, Oka K, Higashi S, Kortylewski M, Pirrotte P, Pal S. Assessment of short-chain fatty acid (SCFA) and circulating cytokine trends in a clinical trial of nivolumab/ipilimumab and CBM588 in metastatic renal cell carcinoma (mRCC). Journal Of Clinical Oncology 2023, 41: 4556-4556. DOI: 10.1200/jco.2023.41.16_suppl.4556.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaNivolumab/ipilimumabObjective response rateShort-chain fatty acidsPlasma short-chain fatty acidsImmune checkpoint blockadeCheckpoint blockadeCytokine levelsSCFA levelsClinical trialsRandomized phase I clinical trialSarcomatoid Metastatic Renal Cell CarcinomaPhase I clinical trialStool SCFA levelsAcid levelsTreatment-naïve patientsAltered amino acid metabolismRenal cell carcinomaIpilimumab armNaïve patientsButyric acid levelsSerum cytokinesClinical outcomesCell carcinomaBiologic rationaleAssociation between intra-tumoral microbiome and clinical benefit (CB) from immunotherapy (IO) in patients with metastatic renal cell carcinoma (mRCC).
Meza L, Choi Y, Zhang J, Dizman N, Zengin Z, Ebrahimi H, Barragan-Carrillo R, Hsu J, Chawla N, Chehrazi-Raffle A, Tripathi A, Castro D, Mercier B, Govindarajan A, Chan A, Schork N, Byron S, Pal S. Association between intra-tumoral microbiome and clinical benefit (CB) from immunotherapy (IO) in patients with metastatic renal cell carcinoma (mRCC). Journal Of Clinical Oncology 2023, 41: 4561-4561. DOI: 10.1200/jco.2023.41.16_suppl.4561.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaClinical benefitLine immunotherapyMicrobial diversityNivolumab/ipilimumabStart of immunotherapyBacterial diversityClear cell histologyPD-L1 expressionRenal cell carcinomaRelative abundanceAvailable RNA sequencing dataRelative microbial abundanceParaffin-embedded samplesRNA sequencing dataRNA-seq readsCell histologyCommon regimenMedian ageLine treatmentCell carcinomaPoor riskShannon diversity indexRCC tumorsImmunotherapyUltrasensitive Circulating Tumor DNA Pilot Study Distinguishes Complete Response and Partial Response With Immunotherapy in Patients With Metastatic Renal Cell Carcinoma
Chehrazi-Raffle A, Muddasani R, Dizman N, Hsu J, Meza L, Zengin Z, Malhotra J, Chawla N, Dorff T, Contente-Cuomo T, Dinwiddie D, McDonald B, McDaniel T, Trent J, Baehner F, Murtaza M, Pal S. Ultrasensitive Circulating Tumor DNA Pilot Study Distinguishes Complete Response and Partial Response With Immunotherapy in Patients With Metastatic Renal Cell Carcinoma. JCO Precision Oncology 2023, 7: e2200543. PMID: 37027813, PMCID: PMC10309555, DOI: 10.1200/po.22.00543.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaPartial responseComplete responseVariant allele fractionRenal cell carcinomaCell carcinomaCtDNA analysisImmune checkpoint inhibitor therapyCheckpoint inhibitor therapyDiscontinuation of immunotherapyDepth of responseICI therapyNivolumab monotherapyEligible patientsRadiographic progressionInhibitor therapyPeripheral bloodDisease progressionCtDNA assessmentSubsequent progressionPatientsMultiple indicationsSingle time pointPatient-specific mutationsSecondary objectiveTwelve-Month Follow-up of the Immune Response After COVID-19 Vaccination in Patients with Genitourinary Cancers: A Prospective Cohort Analysis
Meza L, Zengin Z, Salgia S, Malhotra J, Karczewska E, Dorff T, Tripathi A, Ely J, Kelley E, Mead H, Hsu J, Dizman N, Salgia N, Chawla N, Chehrazi-Raffle A, Muddasani R, Govindarajan A, Rock A, Liu S, Salgia R, Trent J, Altin J, Pal S. Twelve-Month Follow-up of the Immune Response After COVID-19 Vaccination in Patients with Genitourinary Cancers: A Prospective Cohort Analysis. The Oncologist 2023, 28: e748-e755. PMID: 36971500, PMCID: PMC10485287, DOI: 10.1093/oncolo/oyad067.Peer-Reviewed Original ResearchConceptsCOVID-19 vaccinationGenitourinary cancersRenal cell carcinomaBooster doseCell carcinomaImmune responseBlood samplesSevere acute respiratory syndrome coronavirus 2Acute respiratory syndrome coronavirus 2T-cell receptor sequencingRespiratory syndrome coronavirus 2Baseline blood samplesMajority of patientsMinority of patientsProspective cohort analysisSyndrome coronavirus 2Twelve-month followAntibody titer analysisCOVID-19 vaccineSeroconversion ratesMedian ageUrothelial cancerCoronavirus 2Prostate cancerCohort analysisCorrigendum to “Outcomes for International Metastatic Renal Cell Carcinoma Database Consortium Prognostic Groups in Contemporary First-line Combination Therapies for Metastatic Renal Cell Carcinoma” [Eur Urol 2023]
Ernst M, Navani V, Wells J, Donskov F, Basappa N, Labaki C, Pal S, Meza L, Wood L, Ernst D, Szabados B, McKay R, Parnis F, Suarez C, Yuasa T, Lalani A, Alva A, Bjarnason G, Choueiri T, Heng D. Corrigendum to “Outcomes for International Metastatic Renal Cell Carcinoma Database Consortium Prognostic Groups in Contemporary First-line Combination Therapies for Metastatic Renal Cell Carcinoma” [Eur Urol 2023]. European Urology 2023, 83: e166-e167. PMID: 36967358, DOI: 10.1016/j.eururo.2023.03.003.Peer-Reviewed Original ResearchEvaluation of eligibility criteria in contemporary renal cell carcinoma based on ASCO-FCR recommendations.
Prajapati S, Feng M, Castro D, Lee K, Chan E, Sehgal I, Patel J, O'Dell A, Zengin Z, Li X, Chehrazi-Raffle A, Dizman N, Tripathi A, Rock A, Liu S, Mercier B, Meza L, Philip E, Dorff T, Pal S. Evaluation of eligibility criteria in contemporary renal cell carcinoma based on ASCO-FCR recommendations. Journal Of Clinical Oncology 2023, 41: 612-612. DOI: 10.1200/jco.2023.41.6_suppl.612.Peer-Reviewed Original ResearchRestrictive eligibility criteriaEligibility criteriaHCV positivityHIV positivityInclusion criteriaExclusion criteriaExact testClass of therapyReal-world populationRenal cell carcinomaFisher's exact testChi-square testConcurrent malignancyBrain metastasesAdult patientsCell carcinomaCombination therapyPatient populationCancer trialsRCC trialsConsensus statementRadiation therapyClinical OncologyPrognostic toolReal-world setting