Date: {{$ActivityAssignDate}}

Dear Dr. {{$doctorName}},

Subject: Participation in survey “Criteria’s For Selection of Tyrosine Kinase Inhibitors in Metastatic Renal Cell Cancer Management”

According to the GLOBOCAN 2022 estimates, 17480 new cases of kidney cancer were diagnosed in 2022 in India. Renal cell carcinoma (RCC) is the most common form of kidney cancer (90% of cases). It is nearly twice as common in men as in women, with a median age at diagnosis of 64 years. Clear cell tumors are the most common pathological subtype of RCC (80% of cases); other less common subtypes include papillary, chromophobe, and collecting duct tumors. Smoking, obesity, and hypertension are well‑known risk factors for RCC. It primarily metastasizes to the lung, bone, liver, lymph nodes, adrenal gland, and brain.

Renal cell carcinoma (RCC) is highly resistant to systemic chemotherapy, and historically a poor prognosis for metastatic disease has been reported, with a 5‑year survival rate of <10%. Significant advances have been made in the last decade since the introduction of tyrosine kinase inhibitors (TKIs) such as sunitinib, pazopanib, and sorafenib and Immune check point inhibitors such as nivolumab, pembrolizumab, avelumab and ipilimumab.

Although the ICIs based regimens have changed the treatment paradigm in the management of mRCC, TKIs monotherapy is currently the first line treatment of choice in patients who cannot tolerate or afford ICIs based regimens.

There is limited data available on the preference and rationale for selection of different TKIs in the management of mRCC.

This multicentric survey is designed to understand the management of mRCC and place of sunitinib and pazopanib in mRCC management in India.

If you agree to participate, you will be required to respond to questions of the enclosed questionnaire. We trust you and we are partners in promoting safe and effective drug therapy. In that spirit we hope you will consent to participate in this survey. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records..