title: Assessing the impact of evolving evidence in renal cell carcinoma treatment: an update of the Renal Cell Carcinoma Appropriateness-based Treatment Toolkit (ReCATT).
abstract: The appropriateness of the numerous therapeutic options available for patients with advanced or metastatic renal cell carcinoma (RCC) was evaluated in 2011, using the RAND/University of California, Los Angeles (UCLA) appropriateness methodology to match treatment suitability to a range of patient scenarios. However, the RCC therapeutic area evolves rapidly and a body of new clinical data has accrued in the intervening years; as a result the exercise was repeated in 2013 using the same methodology, expert panel and patient scenarios. The aim of the updated assessment was to update the guidance to clinicians and use it to develop an interactive web-based application, the Renal Cell Carcinoma Appropriateness-based Treatment Toolkit (ReCATT). This round of assessment achieved greater concordance concerning the appropriateness of treatments/interventions for the clinical scenarios tested; this higher level of agreement is likely to reflect the body of scientific evidence accrued since the previous assessment exercise. Many of the areas of disagreement in 2011 related to the suitability of pazopanib or sunitinib treatment; in the 2013 assessment both agents were considered appropriate treatment options for many of the clinical scenarios assessed. Uncertain scenarios often are related to the optimal management of metastatic RCC with clear cell histology. The use of the RAND/UCLA RCC assessment findings to develop the ReCATT support tool will help to disseminate expert opinion concerning best treatment practice and guide the clinical management of RCC patients treated in the community setting.
authors.affiliation: Department of Oncology, The Royal Marsden Hospital, Fulham Rd, London SW3 6JJ, UK. Electronic address: martin.gore@rmh.nhs.uk.
authors.forename: M E
authors.initials: ME
authors.lastname: Gore
authors.affiliation: Department of Medical Oncology, University Hospital del Mar-IMIM, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Bellmunt
authors.affiliation: Department of Oncology, Cambridge University Health Partners, Cambridge, UK.
authors.forename: T
authors.initials: T
authors.lastname: Eisen
authors.affiliation: Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France.
authors.forename: B
authors.initials: B
authors.lastname: Escudier
authors.affiliation: Center of Operative Urology Bremen, Bremen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Mickisch
authors.affiliation: Department of Urology, Paris XI Bicetre University Hospital, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Patard
authors.affiliation: Department of Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, San Matteo University Hospital Foundation, Pavia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Porta
authors.affiliation: Department of Medical Oncology, Hôpital Saint André, Bordeaux University Hospital, Bordeaux, France.
authors.forename: A
authors.initials: A
authors.lastname: Ravaud
authors.affiliation: Department of Medicine I, Clinical Division of Oncology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Schmidinger
authors.affiliation: Department of General Medical Oncology and Laboratory of Experimental Oncology, University Hospitals Leuven, Catholic University Leuven, Leuven, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Schöffski
authors.affiliation: Department of Medical Oncology, San Camillo Forlanini Hospital, Rome, Italy.
authors.forename: C N
authors.initials: CN
authors.lastname: Sternberg
authors.affiliation: Department of Oncology, Military Medical Institute, Warsaw, Poland.
authors.forename: C
authors.initials: C
authors.lastname: Szczylik
authors.affiliation: Double Helix Consulting, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Lewis
authors.affiliation: Double Helix Consulting, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Kirpekar
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000628:therapy*; D032921:Consensus; D019317:Evidence-Based Medicine; D006801:Humans; D007680:Kidney Neoplasms / Q000628:therapy*; D009392:Nephrectomy; D057240:Patient Preference; D018570:Risk Assessment / Q000379:methods
chemical_list: D000970:Antineoplastic Agents
keywords: Advanced; Interventions; Metastatic; Renal cell carcinoma; Treatments