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Laura Salabert1, Baptiste Sionneau1, Valérie Cochin1

  • 1Service oncologie médicale, centre hospitalo-universitaire Bordeaux, France.

Bulletin Du Cancer
|January 1, 2019
PubMed
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Combining focal treatments with systemic therapy can delay treatment initiation and allow drug holidays for metastatic renal cell carcinoma patients. This multimodal approach offers local control with low morbidity, improving patient management.

Area of Science:

  • Oncology
  • Nephrology
  • Cancer Treatment

Background:

  • Metastatic renal cell carcinoma (mRCC) treatment often involves oral therapies with side effects impacting patient adherence.
  • Active surveillance and drug holidays are strategies to manage indolent or oligometastatic tumors, potentially delaying systemic treatment without compromising survival.

Purpose of the Study:

  • To explore the benefits of a multimodal approach combining focal treatments with systemic therapy in mRCC.
  • To evaluate strategies for delaying systemic treatment, enabling drug holidays, and managing dissociated responses in mRCC patients.

Main Methods:

  • Review of retrospective studies evaluating focal treatment techniques (metastasectomy, radiofrequency ablation, cryotherapy, stereotactic radiotherapy) in mRCC.
  • Analysis of outcomes related to local control and treatment morbidity.
Keywords:
Cancer du reinFocal treatmentMetastasesMultimodal approachMétastasesPrise en chargeRenal cancerSystemic treatmentTraitementTraitement focalmultimodalesystémique

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Main Results:

  • Focal treatments combined with systemic therapy show promising results in local control of metastases.
  • This multimodal approach is associated with low morbidity, offering potential benefits for patient management and treatment adherence.

Conclusions:

  • A multimodal approach combining focal treatments and systemic therapy is a viable strategy for managing metastatic renal cell carcinoma.
  • Further prospective data collection is needed to validate these practices, especially in the context of checkpoint inhibitor therapies.
  • Multidisciplinary discussion is crucial for optimizing individualized treatment plans for mRCC patients.