Medical treatment of renal cancer: new horizons

Area of Science:

• Oncology
• Immunotherapy
• Renal Cell Carcinoma Research

Background:

• Renal cell carcinoma (RCC) accounts for 2-3% of adult cancers.
• Management of RCC evolved from immunotherapy to targeted therapies like tyrosine kinase inhibitors (TKIs).
• Current trends indicate a resurgence of immunotherapy in RCC treatment.

Purpose of the Study:

• To review current medical and surgical management of localized, oligometastatic, and advanced RCC.
• To discuss the evidence base for managing poor-risk and non-clear cell RCC.
• To explore how recent clinical trial results and immunotherapy advancements will shape future RCC treatment practices.

Main Methods:

• Review of current medical and surgical management strategies for RCC.
• Analysis of evidence for adjuvant treatments in localized RCC.
• Discussion of prognostic criteria and the need for predictive biomarkers in advanced RCC.
• Evaluation of recent clinical trial outcomes, particularly for immunotherapy.

Main Results:

• Immunotherapy, specifically anti-programmed cell death 1 ligand (PD-L1) monoclonal antibody nivolumab, demonstrates prolonged overall survival in metastatic RCC.
• No adjuvant treatment has yet proven beneficial for high-risk localized RCC patients, pending further trial results.
• Treatment selection for metastatic RCC relies on histology, prognostic group, and patient preference.

Conclusions:

• Immunotherapy is experiencing a renaissance in renal cell cancer treatment.
• There is an ongoing need for predictive biomarkers to guide therapy selection in advanced RCC.
• Future practice in RCC management will be shaped by recent clinical trial data and evolving immunotherapy strategies.