Rana R. McKay, MD

Rana R. McKay, MD

The University of California, San Diego

La Jolla, California

Rana R. McKay, MD, is an Associate Professor of Medicine at the University of California, San Diego, and Co-Leader of the Genitourinary Oncology Disease Team at the Moores Cancer Center. She is a board-certified medical oncologist who specializes in treating people with urogenital cancers, including bladder, kidney, prostate, and testicular cancer. Her research interests include the design and implementation of clinical trials to advance the treatment of patients with urologic cancers. She serves as the Principal Investigator of several early phase trials in kidney and prostate cancer. As a clinical investigator, she is committed to advancements that will improve the lives of individuals with cancer. Furthermore, she is interested in understanding mechanisms of response and resistance to specific cancer therapies. Her work has appeared in peer- reviewed publications such as Nature, The Lancet, The Journal of Clinical Oncology, Clinical Cancer Research, Cancer, among others. Dr. McKay earned her medical degree at the University of Florida College of Medicine before completing her residency in Internal Medicine at Johns Hopkins Hospital. She also completed a fellowship in Oncology/Hematology at the Dana-Farber Cancer Institute of Harvard Medical School. She went on to serve as an Assistant Professor at Harvard Medical School and a medical oncologist at Dana-Farber/Brigham and Women’s Cancer Center in Boston before joining UC San Diego Health.

Talks by Rana R. McKay, MD

Metastatic Castrate Sensitive Prostate Cancer

Metastatic Castrate Sensitive Prostate Cancer

Posted by | Dec 2024

Rana McKay, MD, discusses the evolving treatment strategies for metastatic hormone-sensitive prostate cancer (mHSPC), emphasizing advancements over the past decade. In this 20-minute presentation, McKay shares that prostate cancer remains a leading cause of mortality among men. While traditional androgen deprivation therapy (ADT) has long been the cornerstone treatment, newer approaches integrating chemotherapy, androgen receptor signaling inhibitors (ARSIs), and combination regimens have transformed patient outcomes. She refers to landmark studies like CHARTED, LATITUDE, and STAMPEDE, highlighting the benefits of early intensifying treatment and showing significant survival advantages with doublet and triplet therapies. She also shares recent trials, including PIECE-1 and ARASENS, that underscore the effectiveness of adding agents like abiraterone or darolutamide to ADT and docetaxel for high-risk, high-volume disease.

Dr. McKay asserts clinical decision-making now incorporates disease factors such as volume and risk, patient comorbidities, and drug-specific considerations like toxicity profiles and cost. Emerging genomic and molecular tools are poised to refine treatment personalization further, with ongoing trials exploring the optimal integration of novel agents.

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Point-Counterpoint: Management of mCRPC

Posted by | Feb 2022

Rana R. McKay, MD, Associate Professor of Medicine at the University of California, San Diego, and Co-Leader of the Genitourinary Oncology Disease Team at the Moores Cancer Center, and Alan H. Bryce, MD, Medical Director of the Genomic Oncology Clinic at Mayo Clinic Arizona in Scottsdale, debate whether to treat metastatic castration-resistant prostate cancer (mCRPC).

Taking the pro position, Dr. McKay presents on why physicians need to treat mCRPC, as well as come up with additional treatment options to help improve survival for mCRPC patients. She discusses the goals of mCRPC treatment, improved quality of life and overall survival, and displays a chart that summarizes the current landscape of treatment for advanced prostate cancer as she details how androgen receptor (AR) targeting agents are enhancing treatment. Dr. McKay reviews FDA-approved agents in mCRPC, stating that the vast majority both improve overall survival and quality of life. She specifically states that the agents, outside of pembrolizumab, rucaparib, and sipuleucel-T, can potentially increase overall survival by 53.6 months and improve cancer-associated pain, disease-related urinary symptoms, and symptomatic skeletal events. Dr. McKay then shows a graph displaying mCRPC treatment in a clinical practice, suggesting that mCRPC is grossly undertreated based on the vast majority of patients not going beyond first-line treatment. She states that there is little reliable data on the cost effectiveness of treatment and concludes that mCRPC should be treated based on data showing that treatments improve overall survival and quality of life.

Taking the con position, Dr. Bryce makes an argument against treating mCRPC based on the differences between trial and real-world populations, and the challenges of extreme treatments. Dr. Bryce cites quality of life post-treatment, financial toxicity, and patient-centric treatment as cons of mCRPC treatment. He shows a graph of mCRPC treatment management in clinical practice and states that the rapid drop off after first-line therapy could be caused by patient drop outs instead of undertreatment. Dr. Bryce discusses the mCRPC treatment process in detail, focusing on how after the first line of therapy, treatment options become much more extreme and mostly consist of chemo, and most patients only have about a year left to live if they are beyond second-line treatment. He uses a case study of a 73-year-old patient to show how real-world patients can differ from selected trial patients due to how patient selection leads to optimized outcomes. Dr. Bryce reviews data showing that 20% of patients report financial toxicity, something which is associated with anxiety and depression. He concludes that clinicians should exercise prudent judgment in deciding whether or not to treat patients with advanced cancer due to trials testing beyond third-line therapy not reflecting real-world patients and financial toxicity being a significant issue.

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Point-Counterpoint: Management of mCRPC (Pro)

Posted by | Jan 2022

Taking the pro position in a point-counterpoint debate, Rana R. McKay, MD, Associate Professor of Medicine at the University of California, San Diego, and Co-Leader of the Genitourinary Oncology Disease Team at the Moores Cancer Center, presents on why physicians need to treat metastatic castration-resistant prostate cancer (mCRPC), as well as come up with additional treatment options to help improve survival for mCRPC patients. She discusses the goals of mCRPC treatment, improved quality of life and overall survival, and displays a chart that summarizes the current landscape of treatment for advanced prostate cancer as she details how androgen receptor (AR) targeting agents are enhancing treatment. Dr. McKay reviews FDA-approved agents in mCRPC, stating that the vast majority both improve overall survival and quality of life. She specifically states that the agents, outside of pembrolizumab, rucaparib, and sipuleucel-T, can potentially increase overall survival by 53.6 months and improve cancer-associated pain, disease-related urinary symptoms, and symptomatic skeletal events. Dr. McKay then shows a graph displaying mCRPC treatment in a clinical practice, suggesting that mCRPC is grossly undertreated based on the vast majority of patients not going beyond first-line treatment. She states that there is little reliable data on the cost effectiveness of treatment and concludes that mCRPC should be treated based on data showing that treatments improve overall survival and quality of life.

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Overall Survival with Sipuleucel-T in Patients Treated for Advanced Prostate Cancer

Overall Survival with Sipuleucel-T in Patients Treated for Advanced Prostate Cancer

Posted by | Dec 2020

Rana R. McKay, MD, Associate Professor of Medicine at the University of California, San Diego, and Co-Leader of the Genitourinary Oncology Disease Team at the Moores Cancer Center, discusses the results of a study that compared the efficacy of first-line and any-line sipuleucel-T to that of novel hormonal agents in Medicare beneficiaries with metastatic castration-resistant prostate cancer (mCRPC). The intent of the study was to see how the use of sipuleucel-T, which has been available for just over a decade and was the first autologous vaccine approved for a solid tumor, might be impacted by the introduction of so many new therapies for mCRPC in the last 10 years. Dr. McKay explains that the results show that, for the population studied, use of sipuleucel-T, both as first-line and any-line therapy, results in a statistically significant improvement in overall survival compared to patients who never received sipuleucel-T and were instead treated with other novel hormonal agents. Following her presentation, E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology, conducts a Q&A session with Dr. McKay in which they discuss the increasing acceptance of sipuleucel-T among medical oncologists, combination therapies with sipuleucel-T, and the future of sipuleucel-T, among other subjects.

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