Novel approaches in the therapy of metastatic renal cell carcinoma

  title={Novel approaches in the therapy of metastatic renal cell carcinoma},
  author={John S. Lam and John T. Leppert and Arie S. Belldegrun and Robert A. Figlin},
  journal={World Journal of Urology},
Renal cell carcinoma (RCC) is the most lethal of the common urologic malignancies, with approximately 40% of patients eventually dying of cancer progression. Approximately one third of patients present with metastatic disease, and up to 40% treated for localized disease have a recurrence. Recent advances in the understanding of the pathogenesis, behavior, and molecular biology of RCC have paved the way for developments that may enhance early diagnosis, better predict tumor prognosis, and… 
Successes and limitations of targeted therapies in renal cell carcinoma.
Until recently, the standard treatment for metastatic renal cell carcinoma (RCC) was nonspecific immunotherapy based on interleukin-2 or interferon-α, but a new class of therapeutics is emerging in RCC: immunotherapy; in particular check-point blockade antibodies are showing very promising results.
Unified Approaches to Surgery and Systemic Therapy for Renal Cell Carcinoma
There remains no clear role for adjuvant therapy following nephrectomy for clinically localized disease and it has been proposed that neoadjuvant therapy may make unresectable disease resectable, enable partial neph rectomy, or shrink venous tumor thrombus for locally advanced disease.
Management of metastatic renal cell carcinoma in patients with poor prognosis
While patients with poor risk features have a more guarded outcome, treatment with temsirolimus has produced meaningful improvements in overall survival for this population, and ongoing translational research efforts may help to define novel treatment approaches specific for patients with metastatic RCC and poor prognostic features.
Treatment options in renal cell carcinoma: past, present and future.
Results confirm that inhibiting these tumour targets is a feasible approach to treatment and provides a more positive outlook for the future management of metastatic RCC.
ASCO 2006 highlights: targeted therapy for renal cell carcinoma.
Surgical Management of Advanced and Metastatic Renal Cell Carcinoma: A Multidisciplinary Approach
The first immune checkpoint inhibitor was approved for metastatic renal cell carcinoma (mRCC) in 2015, providing a new treatment mechanism and new opportunities for combining systemic therapy with surgery.
Combination therapy for renal cell carcinoma: review of the clinical evidence
There are reasons to believe that immunotherapy and chemotherapy combinations may also be relevant with this disease, and the largest number of such investigations has combined agents within the VEGF-targeted class with mTOR inhibitors.
Second-line strategies for metastatic renal cell carcinoma: classics and novel approaches
Until today, second-line treatment of patients with metastatic RCC progressing under therapy with biological response modifiers remains an unresolved issue.
Cytoreductive nephrectomy in metastatic renal cell carcinoma
With further advances in the understanding of the pathogenesis, behavior and molecular biology of renal cell carcinoma, cytoreductive nephrectomy, in combination with molecular targeted therapies, may become the new standard of care for patients with metastatic renalcell carcinoma.


Pathobiology, prognosis, and targeted therapy for renal cell carcinoma: exploiting the hypoxia-induced pathway.
Molecular mechanisms of the hypoxia-induced pathway that play an essential role in angiogenesis, glycolysis, and apoptosis of common cancers and may be responsible for the ability of the cancers to adapt to a hypoxic environment and also for their resistance to radiation and chemotherapy are reviewed.
Neovastat (AE-941) in refractory renal cell carcinoma patients: report of a phase II trial with two dose levels.
The higher dose of Neovastat administered in this trial is associated with a survival benefit in RCC, which is not explained by differences in major prognostic factors.
Natural history and therapy of metastatic renal cell carcinoma
Despite significant advances in understanding the biology of renal cell carcinoma (RCC) during the past decade, metastatic disease remains nearly incurable and a major medical challenge. Because RCC
Renal-cell carcinoma.
Renal cell carcinoma 2005: new frontiers in staging, prognostication and targeted molecular therapy.
Staging systems for RCC serve as a valuable prognostic tool and urologists will be updated with the most current and comprehensive staging strategies, and be provided with a glimpse of the molecular and patient specific staging and treatment paradigms that will in the authors' opinion transform the future management of this malignancy.
Treatment outcome and survival associated with metastatic renal cell carcinoma of non-clear-cell histology.
RCC consists of a heterogeneous group of tumors including clear-cell, papillary, chromophobe, collecting duct, and unclassified cell types, which constitute less than 10% of patients in general populations of patients with advanced RCC treated on clinical trials.
SU011248, a novel tyrosine kinase inhibitor, shows antitumor activity in second-line therapy for patients with metastatic renal cell carcinoma: Results of a phase 2 trial.
  • R. Motzer, B. Rini, C. Baum
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2004
SU011248 administered in repeat cycles of 50 mg daily for 4 weeks followed by a 2-week rest period exhibits promising antitumor activity as second-line therapy for patients with metastatic RCC.
The treatment of advanced renal cell cancer with high-dose oral thalidomide
Toxicities were of sufficient clinical significance for use of a lower and well tolerated dose of 400 mg in currently accruing studies, and a statistically significant decrease in serum TNF-α levels was demonstrated in patients with SD ≥ 3 months.
A phase II trial of chimeric monoclonal antibody G250 for advanced renal cell carcinoma patients
WX-G250 seems to be able to modulate mRCC, with a median survival of 15 months after the start of this treatment and two late clinical responses, and to improve the activity of WX- G250-specific antibody-dependent cellular cytotoxicity and the clinical response rate.