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SEOM clinical guideline for treatment of kidney cancer (2017)
E Gallardo1, M J Méndez-Vidal2, J L Pérez-Gracia3
1Medical Oncology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Parc Taulí, 1, 08208, Sabadell, Spain.
Abstract:
The goal of this article is to provide recommendations about the management of kidney cancer. Based on pathologic and molecular features, several kidney cancer variants were described. Nephron-sparing techniques are the gold standard of localized disease. After a randomized trial, sunitinib could be considered in adjuvant treatment in high-risk patients. Patients with advanced disease constitute a heterogeneous population. Prognostic classification should be considered. Both sunitinib and pazopanib are the standard options for first-line systemic therapy in advanced renal cell carcinoma. Based on the results of two randomized trials, both nivolumab and cabozantinib should be considered the standard for second and further lines of therapy. Response evaluation for present therapies is a challenge.
Insights
This article offers kidney cancer management guidelines, detailing localized and advanced treatment options. It highlights nephron-sparing surgery for early stages and systemic therapies like sunitinib and pazopanib for advanced renal cell carcinoma.
Area of Science:
- Oncology
- Nephrology
- Medical Guidelines
Background:
- Kidney cancer management involves diverse approaches based on disease stage and subtype.
- Accurate diagnosis and risk stratification are crucial for effective treatment planning.
Purpose of the Study:
- To provide evidence-based recommendations for kidney cancer management.
- To outline current standards for localized and advanced renal cell carcinoma treatment.
Main Methods:
- Review of pathologic and molecular features for kidney cancer variant classification.
- Analysis of randomized trials for adjuvant and systemic therapy efficacy.
- Consideration of prognostic classification for advanced disease.
Main Results:
- Nephron-sparing techniques are the standard for localized kidney cancer.
- Sunitinib may be used as adjuvant treatment for high-risk patients.
- Sunitinib and pazopanib are first-line options for advanced renal cell carcinoma; nivolumab and cabozantinib are recommended for subsequent lines.
Conclusions:
- Current guidelines emphasize tailored treatment strategies for kidney cancer.
- Effective response evaluation remains a challenge in advanced renal cell carcinoma therapy.