The current role for adjuvant and neoadjuvant therapy in renal cell cancer Review


Authors: Gleeson, J. P.; Motzer, R. J.; Lee, C. H.
Review Title: The current role for adjuvant and neoadjuvant therapy in renal cell cancer
Abstract: Purpose of reviewHere we explore the recent and relevant trials for treatment of renal cell cancer (RCC) in the adjuvant and neoadjuvant settings as well as recent updates to the guidelines for RCC management.Recent findingsMost phase III studies of tyrosine kinase inhibitors in the adjuvant setting have been negative. Notably, sunitinib received regulatory approval by the FDA after showing improved disease-free survival in high risk populations. Recent improvements in the genetic classification and understanding of RCC molecular and genetic disorder will hopefully improve patient selection. Meanwhile, recent advances in metastatic RCC treatment, particularly with the combination of tyrosine kinase inhibitors and immune checkpoint inhibitors, have given rise to hope that advances can be made by moving these treatment strategies forward to the adjuvant or neoadjuvant settings.SummaryIn the absence of a clinical trial, observation remains the standard of care. Based on the S-TRAC data, sunitinib is approved for use in the adjuvant setting, and can be considered under select circumstances. Although there is optimism for checkpoint monotherapy and combination therapy in the adjuvant or neoadjuvant setting, ongoing studies will determine clinical benefit and tolerability in this setting. Therefore, for patients with high risk of recurrent disease clinical trials of checkpoint inhibitor therapy are viable options. © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: renal cell cancer; neoadjuvant; adjuvant
Journal Title: Current Opinion in Urology
Volume: 29
Issue: 6
ISSN: 0963-0643
Publisher: Lippincott Williams & Wilkins  
Date Published: 2019-11-01
Start Page: 636
End Page: 642
Language: English
DOI: 10.1097/mou.0000000000000666
PUBMED: 31348025
PROVIDER: scopus
DOI/URL:
Notes: Source: Scopus
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  1. Robert Motzer
    1243 Motzer
  2. Chung-Han   Lee
    157 Lee