| Abstract: |
High-grade/stage clinically localized renal cell carcinoma (RCC) is associated with a significant risk of recurrence following definitive surgical therapy. Various models have been developed to predict the risk of postoperative recurrence based on clinical and pathologic features of the primary tumor. Novel gene-based signatures have also been investigated to further improve these predictive nomograms. Patients at high risk of recurrence may be offered adjuvant systemic therapy with the goal of eradicating micro-metastatic disease, preventing recurrence, and improving survival. To date, systemic-targeted therapies against angiogenesis pathways such as vascular endothelial growth factor (VEGF) and tyrosine kinase inhibitor(s) (TKI) have failed to demonstrate a significant impact on overall survival (OS). Given the effective and durable antitumor activity associated with novel immunotherapies in metastatic RCC, immune checkpoint inhibitor(s) (ICI) are being investigated in the adjuvant setting. This chapter provides a comprehensive summary on clinical-risk prediction models in high-risk localized RCC and insight into clinical trials of systemic therapies in the adjuvant space. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023. |
