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A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Oligometastatic RCC: Challenges and Emerging Therapeutic Strategies
Calliope Stavrou1, Monica Thet1, Kieran Sandhu2,3
1Department of Urology, Royal Melbourne Hospital, Melbourne, VIC 3050, Australia.
Abstract:
Background/objectives: Renal-cell carcinoma (RCC) accounts for approximately 4% of all solid tumours worldwide. Oligometastatic RCC, frequently defined as the presence of fewer than five metastatic lesions, is increasingly recognised as a clinically and prognostically distinct disease state, yet standardised treatment algorithms remain lacking. Method: This narrative review summarises current local and systemic treatment strategies for oligometastatic RCC and identifies patient populations most likely to benefit based on 26 studies published within the past ten years. Results: Stereotactic ablative radiotherapy (SABR) was the most frequently evaluated local modality, consistently demonstrating high local control rates with favourable toxicity profiles. Systemic therapies showed mixed efficacy and greater treatment-related adverse events, while evidence for radiofrequency ablation, cryoablation, and metastasectomy remains limited but suggests feasibility in selected patients. Conclusions: Overall, current evidence supports local therapy-particularly SABR-in appropriately selected patients with oligometastatic RCC, though most available evidence is retrospective and concentrated in favourable-risk ccRCC populations, limiting generalizability. Further prospective research is needed to refine patient selection criteria and optimise treatment sequencing.
Insights
Local therapies, particularly stereotactic ablative radiotherapy (SABR), show promise for oligometastatic renal-cell carcinoma (RCC). Further research is needed to optimize treatment selection and sequencing for this distinct patient group.
Area of Science:
- Oncology
- Urology
Background:
- Renal-cell carcinoma (RCC) represents approximately 4% of global solid tumors.
- Oligometastatic RCC, defined by fewer than five metastases, is a distinct clinical entity lacking standardized treatment.
- Current treatment algorithms for oligometastatic RCC are not well-established.
Purpose of the Study:
- To review current local and systemic treatment strategies for oligometastatic RCC.
- To identify patient populations who may benefit most from specific treatments.
- To summarize evidence from studies published in the last decade.
Main Methods:
- Narrative review of 26 studies from the past ten years.
- Analysis of local and systemic treatment modalities for oligometastatic RCC.
- Evaluation of treatment efficacy and toxicity profiles.
Main Results:
- Stereotactic ablative radiotherapy (SABR) demonstrated high local control rates and favorable toxicity.
- Systemic therapies exhibited variable efficacy and higher adverse events.
- Limited but feasible evidence exists for radiofrequency ablation, cryoablation, and metastasectomy in select patients.
Conclusions:
- Local therapy, especially SABR, is supported for selected oligometastatic RCC patients.
- Current evidence is largely retrospective and focused on favorable-risk clear cell RCC, limiting generalizability.
- Prospective research is essential to refine patient selection and optimize treatment sequencing.
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