Management of metastatic renal cell carcinoma patients with poor-risk features: current status and future perspectives

  title={Management of metastatic renal cell carcinoma patients with poor-risk features: current status and future perspectives},
  author={Matteo Santoni and Michele De Tursi and Alessandra Felici and Giovanni Lo Re and Riccardo Ricotta and Enzo Maria Ruggeri and Roberto Sabbatini and Daniele Santini and Vanja Vaccaro and Michele Milella},
  journal={Expert Review of Anticancer Therapy},
  pages={697 - 709}
With seven agents approved for renal cell carcinoma within the past few years, there has undoubtedly been progress in treating this disease. However, patients with poor-risk features remain a challenging and difficult-to-treat population, with the mTOR inhibitor, temsirolimus, the only agent approved in the first-line setting. Phase III trial data are still lacking VEGF-pathway inhibitors in patients with poor prognostic features. Poor-risk patients need to be considered as a heterogeneous… 
Association of post-treatment hypoalbuminemia and survival in Chinese patients with metastatic renal cell carcinoma
Post-treatment hypoalbuminemia can be considered an independent prognostic factor for patients with mRCC who undergo first-line treatment with tyrosine kinase inhibitors and integrating post-treatment serum albumin level into the basic MSKCC risk model can improve the accuracy of this model in predicting patient overall survival and progression-free survival.
Activity and safety of sunitinib in poor risk metastatic renal cell carcinoma patients.
Sunitinib may benefit some unselected poor-risk patients, although the rates of AEs and drug discontinuation suggest a need for careful patient monitoring.
A case of metastatic renal cell carcinoma showing complete remission after cytoreductive nephrectomy followed by temsirolimus
A 67-year-old woman with poor-risk advanced renal cell carcinoma who had a complete remission after cytoreductive nephrectomy followed by temsirolimus is presented.
Identification of KIF23 as a Prognostic Biomarker Associated With Progression of Clear Cell Renal Cell Carcinoma
Kinesin family member 23 (KIF23) was identified as a prognostic marker inccRCC patients and inhibition of KIF23 expression reduced the proliferation, migration and invasion of ccRCC cells, which provides novel insight into the functions and molecular machinery of Kif23 in ccR CC.
The value of hepatic resection in metastasic renal cancer in the Era of Tyrosinkinase Inhibitor Therapy
LDT should be considered as a suitable additive tool in the era of TKI therapy of MRCC to the liver, which seems to be associated with better OS and PFS, but not DFS.
Comparison of Tyrosine Kinase Inhibitor Versus Mammalian Target of Rapamycin Inhibitor as Second-line Molecular-targeted Therapy for Patients with Poor-risk Metastatic Renal Cell Carcinoma.
Favorable disease control might be achieved by introducing TKI as second-line targeted therapy for patients with poor-risk mRCC by comparing the efficacies of tyrosine kinase inhibitor and mammalian target of rapamycin inhibitor assecond-line molecular-targeted therapy in patients withpoor-risk metastatic renal cell carcinoma.
DACH1 inhibits cyclin D1 expression, cellular proliferation and tumor growth of renal cancer cells
DACH1 was a novel molecular marker of RCC and it attributed to the malignant behavior of renal cancer cells and re-activation of DACH1 may represent a potential therapeutic strategy.
Mediastinal lymph node metastasis of renal cell carcinoma: A case report.
An autopsy-proven case of RCC presenting with a large mediastinal mass is described, previously misdiagnosed as small cell lung carcinoma due to imaging analysis results, an elevated serum level of neuron-specific enolase and the presence of small atypical cells with a high nuclear/cytoplasmic ratio.
Yeast extract inhibits the proliferation of renal cell carcinoma cells via regulation of iron metabolism.
It was determined that reinforced clostridium media for microbiome culture, exerts antitumor effects on renal cell carcinoma cells when compared to the microbiome 'X', and yeast extract could be a candidate for the ingredient driving this phenomenon.


Non-clear cell renal cancer: features and medical management.
  • D. Heng, T. Choueiri
  • Medicine, Biology
    Journal of the National Comprehensive Cancer Network : JNCCN
  • 2009
Although response rates in targeted therapies for papillary RCC may not be as high as those in patients with clear cell histologies, targeted therapy may provide a clinically meaningful response.
Biology of Metastatic Renal Cell Carcinoma
Unraveling the complex mechanisms by which RCC shapes host microenvironment and immune response and therapeutic treatments, in turn, shape both cancer cell biology and tumor-host interactions may hold the key to future advances in such a complex and challenging disease.
Efficacy and safety of vascular endothelial growth factor receptor tyrosine kinase inhibitors in patients with metastatic renal cell carcinoma and poor risk features
VEGFR TKIs, especially sunitinib, are active and tolerated by mRCC patients with poor risk features, and are independent prognostic factors for OS, whereas prior nephrectomy was not.
Selecting patients for cytoreductive nephrectomy in advanced renal cell carcinoma: who and when
Current arguments for Cytoreductive nephrectomy and how to best select patients for surgery are summarized, suggesting that some patients may benefit substantially from CN in the era of targeted therapy.
Targeted therapeutic strategies for the management of renal cell carcinoma
Current and future studies are expected to facilitate the development of therapeutic regimens that incorporate agents with improved tolerability and enhanced efficacy by continuing to capitalize on the strides made by basic and translational scientists in uncovering the mechanisms underlying the various forms of RCC.
Exploratory analysis of the influence of nephrectomy status on temsirolimus efficacy in patients with advanced renal cell carcinoma and poor-risk features
A retrospective subgroup analysis evaluated the influence of prior nephrectomy on outcomes in patients treated with TEMSR or IFN and found no change in survival or progression-free survival for the 2 patient subsets.
Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma.
Progression-free and overall survival with interferon-alpha treatment can be compared with new therapies in phase II and III clinical investigations and the prognostic model is suitable for risk stratification of phase III trials using interferons-alpha as the comparative treatment arm.