The adjuvant treatment of kidney cancer: a multidisciplinary outlook

Camillo Porta, Laura Cosmai, Bradley C. Leibovich, Thomas Powles, Maurizio Gallieni, Axel Bex

Research output: Contribution to journalReview article

6 Scopus citations

Abstract

Approximately 70% of cases of kidney cancer are localized or locally advanced at diagnosis. Among patients who undergo surgery for these cancers, 30–35% will eventually develop potentially fatal metachronous distant metastases. Effective adjuvant treatments are urgently needed to reduce the risk of recurrence of kidney cancer and of dying of metastatic disease. To date, almost all of the tested adjuvant agents have failed to demonstrate any benefit. Only two trials of an autologous renal tumour cell vaccine and of the vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor sunitinib have shown positive results, but these have been criticized for methodological reasons and conflicting data, respectively. The results of two additional trials of targeted agents as adjuvant therapies have not yet been published. Novel immune checkpoint inhibitors are promising approaches to adjuvant therapy in kidney cancer, and a number of trials are now underway. An important component of the management of patients with kidney cancer, particularly those who undergo radical resection for localized renal cell carcinoma, is the preservation of kidney function to reduce morbidity and mortality. The optimal management of these patients therefore requires a multidisciplinary approach involving nephrologists, oncologists, urologists and pathologists.

Original languageEnglish (US)
Pages (from-to)423-433
Number of pages11
JournalNature Reviews Nephrology
Volume15
Issue number7
DOIs
StatePublished - Jul 1 2019

ASJC Scopus subject areas

  • Nephrology

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    Porta, C., Cosmai, L., Leibovich, B. C., Powles, T., Gallieni, M., & Bex, A. (2019). The adjuvant treatment of kidney cancer: a multidisciplinary outlook. Nature Reviews Nephrology, 15(7), 423-433. https://doi.org/10.1038/s41581-019-0131-x