Adjuvant systemic therapy for renal cell carcinoma

    Research output: Chapter in Book/Report/Conference proceedingChapter

    Abstract

    A significant proportion of patients undergoing nephrectomy for renal cell carcinoma remain at high risk of developing metastatic disease. Accurate staging and use of validated prognostic systems are helpful in estimating risk after surgery. At the current time, observation alone remains the standard-of-care after nephrectomy. Numerous systemic strategies have been investigated in the adjuvant setting. Treatment with interferon or interleukin-2, once the mainstay of treating advanced disease, has not shown any benefit in the adjuvant setting. Autologous tumor-derived vaccines have held promise as adjuvant therapy, but while improvements in tumor progression have been suggested in some trials, the data are difficult to interpret and no overall survival advantage has been proven. Small molecules targeting the VEGF and mTOR pathways have significant activity in metastatic renal carcinoma and have changed management of this stage of the disease. Many of these agents are currently being investigated in placebo-controlled adjuvant studies. While results of these trials are still several years away, there is optimism that these agents may prove effective and change the paradigm for treatment of localized renal cell carcinoma.

    Original languageEnglish (US)
    Title of host publicationKidney Cancer: Principles and Practice
    PublisherSpringer Berlin Heidelberg
    Pages172-186
    Number of pages15
    ISBN (Print)9783642218583, 9783642218576
    DOIs
    Publication statusPublished - Jan 1 2012

      Fingerprint

    ASJC Scopus subject areas

    • Medicine(all)

    Cite this

    Ryan, C. (2012). Adjuvant systemic therapy for renal cell carcinoma. In Kidney Cancer: Principles and Practice (pp. 172-186). Springer Berlin Heidelberg. https://doi.org/10.1007/978-3-642-21858-3_11