Perioperative approaches to kidney cancer.

This article provides an overview of the perioperative treatment strategies available for renal cancer. A review of the literature via PubMed, ClinicalTrials.gov, the American Urological Association, and the American Society of Clinical Oncology was used to evaluate the perioperative treatment modalities that best fit renal malignancies according to subtype and stage. For metastatic renal cell carcinoma, among other cancer types, the advent of novel targeted molecular therapies has completely changed the therapeutic landscape. Therapy directed against vascular endothelial growth factor receptor (VEGFR), mammalian target of rapamycin (mTOR), and programmed death 1 (PD-1) has demonstrated clinically robust effects in metastatic disease, leading to significantly enhanced control of the overall tumor burden. Today, systemic therapy is the primary option for advanced kidney cancer. The surgical approach is the mainstay of therapy for localized renal cancer, with systemic options considered only in high-risk patients. More than a decade's worth of clinical trial evaluation has consistently demonstrated a limited contribution of antiangiogenic therapy in localized renal cancer, and the role of multimodality therapy in the localized setting is still evolving. It remains unclear which patients are most likely to benefit from a perioperative approach in metastatic renal cancer. Optimization of timing, choice of presurgical and postsurgical treatment strategies, and choice of neoadjuvan...

Source: Clinical Advances in Hematology and Oncology - June 10, 2020 Category: Cancer & Oncology Tags: Clin Adv Hematol Oncol Source Type: research