Professor Sheng Xinan: Highlights of the 2020 CSCO Kidney Cancer Treatment Guidelines.

Affected by the epidemic situation, the 2020 BOC / boa was held online. The meeting mainly included the most important research progress in various tumor fields, the annual research progress in China, and the update and interpretation of the 2020 version of the guidelines. During the meeting, Professor Sheng Xinan from Peking University Cancer Hospital interpreted the update points of CSCO renal cancer guidelines 2020.details are as follows.for the preoperative staging of renal cell carcinoma, chest CT / X-ray (class 2a) is recommended by the first level experts.genetic testing is recommended for patients with onset age ≤ 45 years old and with bilateral, multifocal and family history of renal cancer.for patients with newly diagnosed metastatic renal cell carcinoma who can tolerate surgery, grade I recommendations include: systemic drug therapy (class 1a), tumor reducing nephrectomy + postoperative systemic drug therapy (class 2a); grade II is recommended to be tumor reducing nephrectomy after systemic drug therapy (category 2a).for patients with intolerance to surgery, systemic drug therapy (class 1a) is recommended for grade I.tumor reduction nephrectomy emphasizes population screening: Based on CARMENA study, it is appropriate to select population for immediate tumor reduction surgery for advanced renal cell carcinoma: generally, the prognosis is good, the prognosis of MSKCC or imDC is moderate, and the primary lesion can be completely removed.patients with postoperative metastases should be stratified according to the type of metastases (oligometastases / local recurrence or multiple metastases). For patients with few metastases / local recurrence and tolerating surgery, surgical resection (class 2a), systemic drug therapy (class 1a), local ablation (class 2a) and stereotactic radiotherapy (class 2b) are recommended for grade II patients with multiple metastases Systemic drug therapy (class 1a) is recommended for grade I.for patients with few metastases and intolerable surgery, systemic drug therapy (class 1a) is recommended for grade I, local ablation (class 2a) and stereotactic radiotherapy (class 2b) are recommended for grade II.this guideline update emphasizes surgical resection of metastases and stereotactic radiotherapy.the recommendation for the first-line treatment of advanced renal cell carcinoma in the Department of internal medicine continued in 2019 according to the risk stratification.different from other guidelines, cytokines are no longer recommended for the treatment of advanced renal cell carcinoma.for the first-line treatment of metastatic or unresectable clear cell renal cell carcinoma in middle and high-risk groups, it is newly added as grade III recommendation.the i-level recommendations for moderate risk population include sunitinib (class 1a), pezopanib (class 1a), cabotinib (class 2a), sorafenib (class 2a), pabolizumab + acitinib (class 1a), navulizumab + ipimab (class 1a); level II recommendations include acitinib (class 2a), pabolizumab (class 2b), bevacizumab + IFN α - 2b (class 1a), and acizumab (class 2a) Verumab + acitinib (class 1a).grade I recommendations for high-risk groups include pabolizumab + acitinib (class 1a), navulizumab + ipimab (class 1a), cabotinib (class 2a), sunitinib (class 1a), pezopanib (class 1a), sorafenib (class 2a); class II recommendations include acitinib (class 2a), pabolizumab (class 2b), bevacizumab + IFN α - 2b (class 1a), and alpha 2b Viluzumab + acitinib (class 1a) and teisirolimus (class 1a).internal medicine part - second line treatment compared with the 2019 version of the guidelines, this year's guidelines add the combination of rivarotinib and pabolizumab, which can be used as a level III recommendation for the follow-up treatment of advanced renal cell carcinoma.this year, ASCO updated a phase II study of ranvastinib + PD-1 monoclonal antibody. The results showed that the orr of the combined regimen was still 59% even with first-line immunotherapy. a phase II study of erlotinib combined with bevacizumab in the treatment of HLRCC / PRCC was published at ASCO meeting this year. The results show that the median PFS of HLRCC is 21.1 months, and that of sporadic PRCC is 8.8 months. Bevacizumab + erlotinib is expected to become the standard treatment for advanced sporadic papillary cell renal cell carcinoma (especially HLRCC). for metastatic or unresectable papillary renal cell carcinoma, bevacizumab + erlotinib is added as grade III recommendation.