Recent advances in the treatment of metastatic renal cell carcinoma expose a gap in the treatment of less advanced,localized disease.Tyrosine kinase inhibitors,which revolutionized the treatment of metastatic disease,...Recent advances in the treatment of metastatic renal cell carcinoma expose a gap in the treatment of less advanced,localized disease.Tyrosine kinase inhibitors,which revolutionized the treatment of metastatic disease,have not provided a similar survival benefit in the adjuvant setting and currently only sunitinib is approved by the Food and Drug Administration for adjuvant treatment in patients with high-risk of recurrence based on S-TRAC disease-free survival data.The advent of immune checkpoint inhibitors has offered a fresh hope in the field of adjuvant treatment after encouraging results are seen with combination of immune checkpoint inhibitors as well as with targeted therapy in the metastatic setting.Several studies are investigating these combinations in the adjuvant setting,and it is hoped that they will bring about a better outcome for a largely unmet need in kidney cancer treatment.展开更多
Metastatic Renal Cell Carcinoma(mRCC)is a highly heterogeneous disease that is notoriously difficult to treat successfully.However,the discovery of novel,targeted therapies over the last decade has revolutionized its ...Metastatic Renal Cell Carcinoma(mRCC)is a highly heterogeneous disease that is notoriously difficult to treat successfully.However,the discovery of novel,targeted therapies over the last decade has revolutionized its management.As the therapeutic options continue to evolve,developing a more individualized treatment strategy is of paramount importance.The International mRCC Database Consortium(IMDC)is a prognostic model that is commonly used in trials and clinical settings to risk stratify patients.This allows for optimal therapy selection on a more individual basis.However,the distinct lack of validated predictive biomarkers in mRCC renders it difficult to assess therapy response.An improved understanding of tumor biology and genetics has prompted a shift from cytokine therapy to the use of vascular endothelial growth factor(VEGF)inhibitors,tyrosine kinase Inhibitors,immune checkpoint inhibitors or combination strategies.Studies have identified some putative markers and genetic mutations as potential predictors of therapy response.Early results are promising,and there are many ongoing trials further assessing their suitability for clinical use.This review will evaluate the current treatment landscape and molecular biology of mRCC,with a specific focus on the prognostic and predictive markers available to guide treatment options and further improve patient outcomes.展开更多
文摘Recent advances in the treatment of metastatic renal cell carcinoma expose a gap in the treatment of less advanced,localized disease.Tyrosine kinase inhibitors,which revolutionized the treatment of metastatic disease,have not provided a similar survival benefit in the adjuvant setting and currently only sunitinib is approved by the Food and Drug Administration for adjuvant treatment in patients with high-risk of recurrence based on S-TRAC disease-free survival data.The advent of immune checkpoint inhibitors has offered a fresh hope in the field of adjuvant treatment after encouraging results are seen with combination of immune checkpoint inhibitors as well as with targeted therapy in the metastatic setting.Several studies are investigating these combinations in the adjuvant setting,and it is hoped that they will bring about a better outcome for a largely unmet need in kidney cancer treatment.
文摘Metastatic Renal Cell Carcinoma(mRCC)is a highly heterogeneous disease that is notoriously difficult to treat successfully.However,the discovery of novel,targeted therapies over the last decade has revolutionized its management.As the therapeutic options continue to evolve,developing a more individualized treatment strategy is of paramount importance.The International mRCC Database Consortium(IMDC)is a prognostic model that is commonly used in trials and clinical settings to risk stratify patients.This allows for optimal therapy selection on a more individual basis.However,the distinct lack of validated predictive biomarkers in mRCC renders it difficult to assess therapy response.An improved understanding of tumor biology and genetics has prompted a shift from cytokine therapy to the use of vascular endothelial growth factor(VEGF)inhibitors,tyrosine kinase Inhibitors,immune checkpoint inhibitors or combination strategies.Studies have identified some putative markers and genetic mutations as potential predictors of therapy response.Early results are promising,and there are many ongoing trials further assessing their suitability for clinical use.This review will evaluate the current treatment landscape and molecular biology of mRCC,with a specific focus on the prognostic and predictive markers available to guide treatment options and further improve patient outcomes.
