Dominick Bosse, MD, fellow, Dana-Farber Cancer Institute, discusses bone-targeted agents for patients with renal cell carcinoma (RCC).

Bone-targeted agents are used in RCC but are a part of supportive care, says Bosse. It is controversial because part of the data come from a small subset of heterogeneous larger trials that were carried on before the era of targeted therapy. Now that there are so many options for the treatment of patients with RCC, it is harder to determine which regimen is the best choice, adds Bosse.

Bone-targeted agents are still used but need to be used carefully, particularly when combined with VEGF-targeted agents, as they can increase side effects. It is reserved for patients with bone pain or a higher burden of bone disease.

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Dr. Bosse Discusses Bone-Targeted Agents in RCC

Dominick Bosse, MD, fellow, Dana-Farber Cancer Institute, discusses the quality of life when combining VEGF-targeted therapies and radium-223 dichloride (Xofigo) in metastatic renal cell carcinoma (mRCC).

There was a secondary endpoint that looked at quality of life, according to Bosse. There was no decrease in pain or improvement of quality of life. This is probably because the entry criteria allowed a maximum of patients with bone disease. The survival of these patients was very short, states Bosse.

Dr. Bosse on the Quality of Life With VEGF Plus Radium-223

Dominick Bosse, MD, fellow, Dana-Farber Cancer Institute, discusses the safety profile demonstrated with the combination of radium-223 dichloride (Xofigo) and VEGF-targeted therapy for patients with renal cell carcinoma (RCC).

The combination of radium-223 and VEGF-targeted agents is feasible and safe. There was no dose limiting toxicity with the combination. There is a particular interest in investigating hematologic toxicity because radium-223 can affect bone marrow, says Bosse.

The toxicity profile is reassuring and overlaps what is known with VEGF targeted therapy, states Bosse. There was only one event of grade 3 anemia, which was not unexpected in the RCC population.

Dominick Bosse, MD, fellow, Dana-Farber Cancer Institute, discusses the safety profile demonstrated with the combination of radium-223 and VEGF-targeted therapy for patients with renal cell carcinoma (RCC).

Dr. Bosse on the Safety Profile With Radium-223 Plus VEGF in RCC

Dominick Bosse, MD, fellow, Dana-Farber Cancer Institute, discusses the rationale behind combining VEGF-targeted therapies and radium-223 dichloride (Xofigo) in metastatic renal cell carcinoma (mRCC).

In a study of patients with mRCC with bone metastases, pazopanib (Votrient) or sorafenib (Nexavar) was combined with radium-223. Primary endpoints were safety, efficacy and bone turnover markers.

Dominick Bosse, MD, fellow, Dana-Farber Cancer Institute, discusses the rationale behind combining VEGF-targeted therapies and radium-223 dichloride (Xofigo) in metastatic renal cell carcinoma.

Dominick Bosse, MD

Articles

Dr. Bosse Discusses Bone-Targeted Agents in RCC

Dr. Bosse on the Quality of Life With VEGF Plus Radium-223

Dr. Bosse on the Safety Profile With Radium-223 Plus VEGF in RCC

Dr. Bosse on Rationale Behind Study of VEGF Plus Radium-223 in RCC