Health article

Targeted Therapy–Immunotherapy Combination for Kidney Cancer

by NCI Staff

PET scan of a tumor in the right kidney (arrows).

Credit: Onco Targets Ther Feb 2014. doi: 10.2147/OTT.S58089. CC-BY 3.0

On April 19, 2019, the Food and Drug Administration approved pembrolizumab (Keytruda) in combination with axitinib (Inlyta) for the initial treatment of people with advanced kidney cancer. The approval was based on the results of the KEYNOTE-426 clinical trial, which found that the combination improved how long patients lived overall and without their disease progressing. Further details on the trial results are discussed in the article below.

Results from two large clinical trials are expected to change the initial treatment for many people with newly diagnosed advanced kidney cancer.

In both studies, combination treatments that included a type of immunotherapy called an immune checkpoint inhibitor and the targeted therapy axitinib (Inlyta) led to better outcomes for patients with advanced kidney cancer than treatment with sunitinib (Sutent) alone, the standard of care for first-line therapy.

Results for the two phase 3 trials were reported last month at the American Society of Clinical Oncology Genitourinary Cancers Symposium (GU ASCO) in San Francisco and simultaneously published in the New England Journal of Medicine (NEJM).

The Food and Drug Administration (FDA) has already approved one immunotherapy combinationalready approved one immunotherapy combination as an initial, or first-line, treatment for people with advanced kidney cancer. And, based on these new data, several experts on the disease said further approvals for these patients are likely to be forthcoming.

“There’s a lot of exciting data. The treatment landscape is changing quickly,” said David McDermott, M.D., chief of medical oncology at Beth Israel Deaconess Medical Center, who has been involved in kidney cancer immunotherapy studies.

Evolving Treatment Strategies for Advanced Renal-Cell Cancer

In the last 12 years,

Health article

NIMH » I’m So Stressed Out! Fact Sheet

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Feeling overwhelmed? Read this fact sheet to learn whether it’s stress or anxiety, and what you can do to cope.

Is it stress or anxiety?

Life can be stressful—you may feel stressed about performance at school, traumatic events (such as a pandemic, natural disaster, or act of violence), or a life change. Everyone feels stress from time to time.

What is stress? Stress is the physical or mental response to an external cause, such as having a lot of homework or having an illness. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time.

What is anxiety? Anxiety is your body’s reaction to stress and can occur even if there is no current threat.

If that anxiety doesn’t go away and begins to interfere with your life, it could affect your health. You could experience problems with sleeping, or with your immune, digestive, cardiovascular, and reproductive systems. You also may be at higher risk for developing a mental illness such as an anxiety disorder or depression. Read more about anxiety disorders.

So, how do you know when to seek help?

Stress vs. Anxiety

StressBoth Stress and AnxietyAnxiety
  • Generally is a response to an external cause, such as taking a big test or arguing with a friend.
  • Goes away once the situation is resolved.
  • Can be positive or negative. For example, it may inspire you to meet a deadline, or it may cause you to lose sleep.
Both stress and anxiety can affect your mind and body. You may experience symptoms such as:
  • Excessive worry
  • Uneasiness
  • Tension
  • Headaches or body pain
  • High blood pressure
  • Loss of sleep
  • Generally is internal, meaning it’s your reaction to stress.
  • Usually involves
Health article

Liquid Biopsy for Brain Cancer, Early-Stage Kidney Cancer

by NCI Staff

Researchers are studying liquid biopsies for detecting cancer that identify patterns of chemical tags, called methyl groups, on DNA in blood or other body fluids.

Credit: National Human Genome Research Institute

A test that analyzes DNA in blood accurately identified two kinds of cancer, according to two new studies.

The test was able to identify kidney cancer at its earliest as well as more advanced stages and to identify and classify different types of brain tumors, including low-grade and more aggressive brain cancers. The same test also showed promise for diagnosing kidney cancer using DNA from urine samples.

If the findings are borne out by further studies, the test—a type of liquid biopsy—could be used to help diagnose kidney cancer and brain cancer without the need for invasive tissue biopsies, which can be risky and costly, said neurosurgeon Chetan Bettegowda, M.D., Ph.D., of the Sidney Kimmel Cancer Center at Johns Hopkins University Medical School, who was not involved with the new studies.

“These results are quite exciting. They represent the early phases of a technology that may prove to be very powerful and enhance our ability to care for cancer patients,” Dr. Bettegowda said. 

“About one-third of kidney cancers are diagnosed at later stages, when they’re harder to cure,” said Matthew Freedman, M.D., Ph.D., a medical oncologist at Dana-Farber Cancer Institute and co-senior investigator on the new kidney cancer study. No markers in blood or urine have been approved by the Food and Drug Administration to indicate the presence of early kidney cancer. And earlier detection of kidney cancer could reduce deaths from the disease, he said.

Similarly, the ability to noninvasively detect and classify brain tumors before surgery could help doctors determine the best course of treatment, better plan surgery,

Health article

How concussions affect kids and teens

Christina Master, M.D.

Concussions among professional athletes have been covered widely in the media. But Christina Master, M.D., co-director of the concussion program at Children’s Hospital of Philadelphia, thinks more attention should be paid to brain injuries in children and teens.

The latest figures show that each year in the U.S. about 283,000 children under the age of 18 visit the emergency room for recreation-related traumatic brain injuries, including concussion. Injuries from playground activities and contact sports—especially football, soccer, and basketball—make up nearly half these visits.

Greater awareness of concussions at the pro athlete level “has certainly trickled down to the youth athlete level” and has sparked more research in recent years, Dr. Master says.

New research paths

Many of these new studies are changing our ideas about treatment and diagnosis, for example, how long a full recovery takes and the differences in concussion between girls and boys.

“The idea of sitting in a dark room after a concussion is probably going by the wayside.”

– Christina Master, M.D.

Dr. Master has worked on recent National Institutes of Health-funded studies that have looked at new, quicker, and more objective ways to diagnose concussion. These include simple balance tests in a doctor’s office and eye tracking tests that can tell if a brain injury happened.

Research also shows that one in six children between the ages of 5 and 15 who get a concussion will have another one within two years. A recent study of Children’s Hospital of Philadelphia patients found that the risk of repeat injury was highest among the oldest kids.

Rethinking recovery

Research suggests that kids who have suffered a concussion may need more help at school and with sports as they recover. But light exercise, such as walking on a treadmill or riding a stationary bike, could