Adjuvant Therapy for Renal Cell Carcinoma: Hype or Hope?
Renal cell carcinoma (RCC) is the third most common genitourinary cancer accounting for approximately 180,000 deaths worldwide in 2020. Although over two-thirds of patients initially present localized disease, up to 50% of them may progress to metastatic disease. Adjuvant therapy aims to reduce the...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/4/4243 |
| _version_ | 1797620354065104896 |
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| author | Federica Cosso Giandomenico Roviello Gabriella Nesi Sonia Shabani Pietro Spatafora Donata Villari Martina Catalano |
| author_facet | Federica Cosso Giandomenico Roviello Gabriella Nesi Sonia Shabani Pietro Spatafora Donata Villari Martina Catalano |
| author_sort | Federica Cosso |
| collection | DOAJ |
| description | Renal cell carcinoma (RCC) is the third most common genitourinary cancer accounting for approximately 180,000 deaths worldwide in 2020. Although over two-thirds of patients initially present localized disease, up to 50% of them may progress to metastatic disease. Adjuvant therapy aims to reduce the recurrence risk and improve outcomes in several types of cancers but is currently an unmet need in RCC. The results achieved with tyrosine kinase inhibitors in metastatic RCC led to the evaluation of these target therapies in an early setting with conflicting results for disease-free survival and no overall survival (OS) benefit. Likewise, the results of immune checkpoint inhibitors (ICIs) in an adjuvant setting are conflicting. Available data did not show an improvement in OS with ICIs in the early phase, although a positive trend for pembrolizumab has been recorded, receiving the Food and Drug Administration’s approval in this setting. However, the disappointing results of several ICIs and the heterogeneous pattern of RCC warrant biomarker identification and subgroup analyses to evaluate which patients could benefit from adjuvant therapy. In this review, we will discuss the rationale for adjuvant treatment in RCC, summarizing the results of the most important adjuvant therapy trials and current applications, to outline possible future directions. |
| first_indexed | 2024-03-11T08:40:04Z |
| format | Article |
| id | doaj.art-b5f0149c3c304e3da42166a07839a660 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-11T08:40:04Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-b5f0149c3c304e3da42166a07839a6602023-11-16T21:11:34ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-02-01244424310.3390/ijms24044243Adjuvant Therapy for Renal Cell Carcinoma: Hype or Hope?Federica Cosso0Giandomenico Roviello1Gabriella Nesi2Sonia Shabani3Pietro Spatafora4Donata Villari5Martina Catalano6School of Human Health Sciences, University of Florence, 50134 Florence, ItalyDepartment of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, 50139 Florence, ItalyDepartment of Health Sciences, Section of Pathological Anatomy, University of Florence, 50139 Florence, ItalySchool of Human Health Sciences, University of Florence, 50134 Florence, ItalyUnit of Urological Robotic Surgery and Renal Transplantation, Careggi Teaching Hospital, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyDepartment of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, 50139 Florence, ItalyRenal cell carcinoma (RCC) is the third most common genitourinary cancer accounting for approximately 180,000 deaths worldwide in 2020. Although over two-thirds of patients initially present localized disease, up to 50% of them may progress to metastatic disease. Adjuvant therapy aims to reduce the recurrence risk and improve outcomes in several types of cancers but is currently an unmet need in RCC. The results achieved with tyrosine kinase inhibitors in metastatic RCC led to the evaluation of these target therapies in an early setting with conflicting results for disease-free survival and no overall survival (OS) benefit. Likewise, the results of immune checkpoint inhibitors (ICIs) in an adjuvant setting are conflicting. Available data did not show an improvement in OS with ICIs in the early phase, although a positive trend for pembrolizumab has been recorded, receiving the Food and Drug Administration’s approval in this setting. However, the disappointing results of several ICIs and the heterogeneous pattern of RCC warrant biomarker identification and subgroup analyses to evaluate which patients could benefit from adjuvant therapy. In this review, we will discuss the rationale for adjuvant treatment in RCC, summarizing the results of the most important adjuvant therapy trials and current applications, to outline possible future directions.https://www.mdpi.com/1422-0067/24/4/4243adjuvant therapyrenal cell carcinomatyrosine kinase inhibitorscancer immunotherapycheckpoint inhibitors |
| spellingShingle | Federica Cosso Giandomenico Roviello Gabriella Nesi Sonia Shabani Pietro Spatafora Donata Villari Martina Catalano Adjuvant Therapy for Renal Cell Carcinoma: Hype or Hope? International Journal of Molecular Sciences adjuvant therapy renal cell carcinoma tyrosine kinase inhibitors cancer immunotherapy checkpoint inhibitors |
| title | Adjuvant Therapy for Renal Cell Carcinoma: Hype or Hope? |
| title_full | Adjuvant Therapy for Renal Cell Carcinoma: Hype or Hope? |
| title_fullStr | Adjuvant Therapy for Renal Cell Carcinoma: Hype or Hope? |
| title_full_unstemmed | Adjuvant Therapy for Renal Cell Carcinoma: Hype or Hope? |
| title_short | Adjuvant Therapy for Renal Cell Carcinoma: Hype or Hope? |
| title_sort | adjuvant therapy for renal cell carcinoma hype or hope |
| topic | adjuvant therapy renal cell carcinoma tyrosine kinase inhibitors cancer immunotherapy checkpoint inhibitors |
| url | https://www.mdpi.com/1422-0067/24/4/4243 |
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