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Renal Cell Carcinoma (RCC)
U.S. Fact Sheet
Renal cell carcinoma (RCC), a type of kidney cancer, is a relatively rare and serious disease in which the
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cancerous process starts in certain areas of the kidney. Early stage renal cancers tend to have a better
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prognosis, while advanced/metastatic cancers have a worse prognosis.
Facts and Figures
 In the United States, approximately 60,000 new cases of RCC are diagnosed each year and approximately
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13,000 patients were expected to die from the disease.
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 At diagnosis, approximately 20 percent of RCC patients will have advanced (metastatic) disease.
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 When the tumor is confined to the kidney, five-year survival may be as high as 80-95 percent.
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o Five year survival rates for patients with advanced RCC remain low, in the 10 to 20 percent range.
 Improvements in imaging techniques have led to an increasing number of incidentally diagnosed RCC cases
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that are smaller and of lower stage than historically seen.
Risk Factors
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 Smoking: Cigarette smoking doubles the risk of developing RCC.
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 Obesity: Research has often shown a link between kidney cancer and obesity. Some doctors think obesity
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is a factor in 20 percent of people who get this cancer.
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 Gender: Men are two to three times more likely to develop RCC than women.
 Family history and genetics: People with a strong family history of RCC have a higher chance of
developing this cancer. Certain genetic conditions including von Hippel-Lindau disease, a rare inherited
disorder characterized by the abnormal growth of blood vessels in certain parts of the body, may also
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increase the risk of developing RCC.
Biology of Renal Cell Carcinoma
 Vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) are two proteins found
at high levels in patients with renal cell carcinoma. Overproduction of these proteins in RCC patients is often
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caused by a genetic mutation, the most common of which is the inactivation of the von Hippel-Landau gene.
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 VEGF and PDGF are important to the growth and survival of tumors .
o High VEGF levels lead to a process called angiogenesis – the formation of new blood vessels that
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feed the tumor.
o High PDGF levels lead to the maturation and survival of newly formed and existing blood vessels and
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supporting tissue.
o In addition, increased levels of PDGF may be associated with tumor progression in renal cell
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carcinomas.
 The mammalian target of rapamycin (mTOR) pathway has also been shown to play a central role in the
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regulation of cell growth and increasing evidence suggests its dysregulation in cancer.
o The mTOR pathway contributes to many critical cellular functions, including angiogenesis, and recent
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studies have shown that the mTOR pathway is strongly activated in RCC patients.
Diagnosis and Treatment
 Symptoms of RCC may include blood in the urine, a lump in the side or back, pain in the side that doesn’t go
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away, tiredness, loss of appetite, weight loss, or anemia, a deficiency of red blood cells.
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 The main treatment for early-stage RCC is surgery.
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o However, many kidney cancers are often found at a late stage when they are harder to treat.
 Until 2005, there were limited treatment options available and interleukin-2 and interferon alfa were widely
used as first-line treatment of metastatic disease. Historically, median overall survival rates for patients
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treated with these therapies were approximately 12 months.
 Since 2005, several drugs have been approved by regulatory agencies for advanced renal cell
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carcinoma,
which have greatly impacted how this disease is managed, and more are in
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development.
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May 2012
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American Cancer Society. Detailed Guide: Kidney Cancer. (Adult) – Renal Cell Carcinoma. Available at:
http://www.cancer.org/acs/groups/cid/documents/webcontent/003107 -pdf.pdf. Acessed May 9, 2012.
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Lynch, C. F., West, M. M., Davila, J. A., & Platz, C. E. (n.d.). SEER Survival Monograph: Chapter 24 Cancers of the Kidney
and Renal Pelvis. National Cancer Institute. Available at: http://seer.cancer.gov/publications/survival/surv_kidney.pdf.
Accessed Jan. 3, 2012.
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National Cancer Comprehensive Network. Practice Guidelines in Oncology: Kidney Cancer. 2009.
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SEER Cancer Statistics Review, 1975-2008, National Cancer Institute. Bethesda, MD, based on November 2010 SEER data
submission. Available online at http://seer.cancer.gov/statfacts/html/kidrp.html. Accessed May 9, 2012. .
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Lam JS, Breda A, Belldegrun AS and Figlin RA. Evolving principles of surgical management and prognostic factors for
outcome in renal cell carcinoma. J Clin Oncol. 2008;24:5565 -5575.
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Cancer.net. Kidney cancer risk factors and prevention. Available at:
http://www.cancer.net/patient/Cancer+Types/Kidney+Cancer?sectionTitle=Risk%20Factors%20and%20Prevention . Accessed
May 9, 2012.
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George D et al. The von Hippel-Lindau Protein, Vascular Endothelial Growth Factor, and Kidney Cancer. The New England
Journal of Medicine. 2003; 349: 419-421.
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Ferrara N, Gerber H-P, LeCouter J. The biology of VEGF and its receptors. Nat Med. 2003;9:669-676.
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Yu J, Ustach C, Choi Kim H-R. Platelet-derived growth factor signaling and human cancer. J Biochem Mol Biol. 2003;36:4959.
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Pantuck A et al. Prognostic Relevance of the mTOR Pathway in Renal Cell Carcinoma. Cancer. 2007; 109: 2257-2267.
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Cancer.net. Kidney cancer: Symptoms and Signs. Available at:
http://www.cancer.net/patient/Cancer+Types/Kidney+Cancer?sectionTitle=Symptoms and Signs . Accessed May 9, 2012.
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National Cancer Institute. What you need to know about kidney cancer: Treatment. Available at:
http://www.cancer.gov/cancertopics/wyntk/kidney/page8. Accessed May 9, 2012.
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Motzer RJ, Hutson TE, Tomczak P et al. Sunitinib versus interferon alfa in metasttic renal-cell carcinoma. N Engl J
Med.2007; 356:115-124.
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SUTENT (sunitinib malate) Prescribing Information. Pfizer Inc.
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TORISEL (temsirolimus) Prescribing Information. Wyeth Pharmaceuticals.
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NEXAVAR (sorafenib) Prescribing Information. Bayer Pharmaceuticals/Onyx.
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AVASTIN (bevacizumab) Prescribing Information. Genentech Inc.
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AFINITOR (everolimus) Prescribing Information. Novartis Oncology.
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VOTRIENT (pazopanib) Prescribing Information. GlaxoSmithKline.
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INLYTA (axitinib) Prescribing Information. Pfizer Inc.
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Clinicaltrials.gov. A Study of Tivozanib (AV-951), on Oral VEGF Receptor Tyrosine Kinase Inhibitor, in the Treatment of
Renal Cell Carcinoma. Available at:
http://www.clinicaltrials.gov/ct2/show/NCT00502307?term=AV+951&cond=renal+cell+carcinoma&rank=4 . Accessed May 9,
2012.
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May 2012