Non-clear cell renal cancer: disease-based management and opportunities for targeted therapeutic approaches

W Marston Linehan1, Ramaprasad Srinivasan, Jorge A Garcia

  • 1Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA. WML@nih.gov

Seminars in Oncology
|August 27, 2013
PubMed

Insights

Novel therapies for non-clear cell renal cell carcinoma (RCC) are needed. Current treatments targeting vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) show limited efficacy in these subtypes.

Area of Science:

  • Oncology
  • Genitourinary Cancer
  • Translational Research

Background:

  • Renal cell carcinoma (RCC) treatment has advanced, with new vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) inhibitors.
  • Clear cell RCC is the most common subtype, and most clinical trials focus on it.
  • Non-clear cell RCC (nccRCC) comprises 20-25% of RCC cases and includes diverse subtypes with distinct molecular profiles.

Purpose of the Study:

  • To review the molecular and clinical characteristics of nccRCC subtypes.
  • To highlight the limited efficacy of current VEGF and mTOR inhibitors in nccRCC.
  • To discuss the need for targeted therapies specific to nccRCC biology.

Main Methods:

  • Literature review of molecular and clinical data for nccRCC subtypes.
  • Analysis of current treatment strategies and their limitations in nccRCC.
  • Examination of ongoing research for novel nccRCC agents.

Main Results:

  • nccRCC subtypes exhibit varied molecular profiles, often unrelated to the von Hippel-Lindau (VHL) gene.
  • Existing VEGF and mTOR inhibitors demonstrate limited clinical efficacy across nccRCC histologies.
  • There is a significant unmet need for subtype-specific therapeutic approaches in nccRCC.

Conclusions:

  • Developing targeted therapies for each nccRCC subtype is crucial.
  • Future research should focus on the unique biology of non-clear cell histologies.
  • Rational therapeutic strategies are needed to improve outcomes for nccRCC patients.

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