1. Caso Clínico Enrique Grande Head of Medical Oncology
Director of Clinical Research

2. Disclosures Honoraria for ad boards and/or lectures:
Pfizer, BMS, IPSEN, Roche, Eisai, Eusa Pharma, MSD, Sanofi-Genzyme, Adacap, Novartis, Pierre Fabre, Lexicon, Celgene
Research Grants:
Pfizer, Astra Zeneca, MTEM/Threshold, Roche, IPSEN, Lexicon
Leadership roles in medical societies:
ENETS, GETNE and GETHI
Stocks or ownership interest:
None

3. Real Cases

4. Our own experience with NIVO + IPI in 1st Line mRCC with poor risk component
June 2016
October 2016
November 2016
65 y.o. woman
Nephrectomy due to left kidney primary tumor in 2013
ECOG 2 (pain, haemoptysis, dyspnoea)
Hb 10.6 g/ml
LDH 1.239
Recruited for CheckMate 214 trial
Started Nivo+IPI in July 2016
Enrique Grande. *unpublished data

5. Our own experience with NIVO + IPI in 1st Line mRCC with sarcomatoid component
March 2016
August 2016
March 2017
60 y.o. male
Nephrectomy due to left kidney primary tumor in February 2016
Sarcomatoid 35% component
Recruited for CheckMate 214 trial
Started NIVO + IPI in May 2016
Enrique Grande. *unpublished data

6. Case scenarios

7. Patient profile 77 y.o. Lung and lymph nodes metastasis ECOG 1
Recently diagnosed
2 adverse prognostic factors by Heng`s score
Adapted from Grande E, et al. World J Clin Oncol 2017

8. Patient profile 77 y.o. Lung and lymph nodes metastasis ECOG 1
Recently diagnosed
2 adverse prognostic factors by Heng`s score
41 y.o.
Lung and lymph nodes metastasis
ECOG 1
Recently diagnosed
2 adverse prognostic factors by Heng`s score
Adapted from Grande E, et al. World J Clin Oncol 2017

9. Tumor Volume
Adapted from Grande E, et al. World J Clin Oncol 2017

10. Intermediate-risk group mostly comprised of three subgroups
MSKCC
IMDC
1 risk factor: 59%
2 risk factors: 41%
1 risk factor: 59%
2 risk factors: 41%
Low serum Hg
16.4%
Low serum Hg
13.3%
Low serum Hg &
<1 year from Dx to Tx
29.4%
Low serum Hg &
<1 year from Dx to Tx
24.6%
<1 year from Dx to Tx
36.0%
<1 year from Dx to Tx
38.3%
Sella A, et al. Clin Genitourin Cancer 2018

11.
@drenriquegrande