Response to systemic therapy in locally advanced and metastatic renal cell carcinoma: can it be predicted?

Author(s):  
Javier González ◽  
Jeffrey J Gaynor ◽  
Gaetano Ciancio
Urology ◽  
2017 ◽  
Vol 108 ◽  
pp. 114-121 ◽  
Author(s):  
Lisly Chéry ◽  
Leonardo D. Borregales ◽  
Bryan Fellman ◽  
Diana L. Urbauer ◽  
Naveen Garg ◽  
...  

2011 ◽  
Vol 9 (9) ◽  
pp. 985-993 ◽  
Author(s):  
Robert Torrey ◽  
Philippe E. Spiess ◽  
Sumanta K. Pal ◽  
David Josephson

Both locally advanced and metastatic renal cell carcinoma (RCC) present a challenge in terms of their optimal management. This article reviews the literature and evaluates the role of surgery in the treatment of advanced RCC. Surgery is the optimal treatment for locally advanced RCC and minimal, resectable, metastatic disease. Patients with metastatic disease, and some forms of locally advanced disease, may also benefit from multimodal management with local surgical therapy and systemic treatment using either immunotherapy or targeted therapy. Regardless of the disease stage, patients with locally advanced or metastatic RCC represent heterogenous patient populations with different disease characteristics and risk factors. Individualization of care in the setting of a sound oncologic framework may optimize the risk/benefit ratio within individual patient cohorts.


Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2911
Author(s):  
Alexandr Poprach ◽  
Milos Holanek ◽  
Renata Chloupkova ◽  
Radek Lakomy ◽  
Michal Stanik ◽  
...  

The role of cytoreductive nephrectomy (CN) in treatment of locally advanced or metastatic renal cell carcinoma (mRCC) in the era of targeted therapies (TT) is still not clearly defined. The study population consisted of 730 patients with synchronous mRCC. The RenIS (Renal carcinoma Information System) registry was used as the data source. The CN/TT cohort included patients having CN within 3 months from the mRCC diagnosis and subsequently being treated with TT, while the TT cohort included patients receiving TT upfront. Median progression-free survival from the first intervention was 6.7 months in the TT arm and 9.3 months in the CN/TT patients (p < 0.001). Median overall survival was 14.2 and 27.2 months, respectively (p < 0.001). Liver metastasis, high-grade tumor, absence of CN, non-clear cell histology, and MSKCC (Memorial Sloan-Kettering Cancer Center) poor prognosis status were associated with adverse treatment outcomes. According to the results of this retrospective study, patients who underwent CN and subsequently were treated with TT had better outcomes compared to patients treated with upfront TT. The results of the study support the use of CN in the treatment algorithm for mRCC.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Sei Naito ◽  
Osamu Ichiyanagi ◽  
Tomoyuki Kato ◽  
Hidenori Kanno ◽  
Takafumi Narisawa ◽  
...  

Abstract Data on the outcomes of third- or fourth-line therapy for metastatic renal cell carcinoma (mRCC) are limited. The aim of our study was to evaluate the efficacy of therapy beyond the second line. We retrospectively analysed data of mRCC patients who underwent systemic therapy at Yamagata University Hospital. The best objective response (BOR), response rate (RR), and progression-free survival (PFS) were assessed for each line of treatment. To investigate the correlation between overall survival (OS) and the number of treatment lines during a patient’s lifetime, the median OS was assessed using univariate and multivariate analyses. In the first-, second-, and third-line therapies, approximately 20% of patients had long PFS of >15 months. In targeted treatments beyond the third line, only one treatment suppressed disease progression for >10 months. Among patients who died during the follow-up period, those treated with triple and quadruple lines had similar OS (42.5 months vs. 48.4 months, respectively). Multivariate analysis showed that patients with triple or more lines of therapy had better OS; however, quadruple or more lines of therapy was not an independent prognostic factor. We concluded that third-line systemic therapy could improve OS; however, fourth-line therapy could not.


1993 ◽  
Vol 60 (4) ◽  
pp. 305-306
Author(s):  
S. Benvenuti ◽  
E. Gastaldi ◽  
B. Mennini ◽  
M. Iacoviello ◽  
M. Caviguone ◽  
...  

10 patients with locally advanced renal cell carcinoma and 5 patients with metastatic renal cell carcinoma were treated with IL-2 subcutaneously. Adverse effects were not important. This study shows that IL-2 alone given subcutaneously is an effective and well-tolerated treatment for renal cell carcinoma.


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