The Current State of Adjuvant Therapy Following Surgery for High-risk Renal Cell Carcinoma

Eur Urol Focus. 2019 Nov;5(6):935-938. doi: 10.1016/j.euf.2019.03.020. Epub 2019 Apr 8.

Abstract

Cancer recurs in up to 40% of patients following surgery for high-risk, locoregional renal cell carcinoma (RCC). To date, little progress has been made in identifying systemic adjuvant treatment options to reduce the mortality risk after surgery for high-risk RCC. Several randomized trials exploring the efficacy of adjuvant targeted therapies in the postoperative setting have recently reported results. We examine these trials to assess the contemporary role of targeted therapy following surgery in high-risk RCC and briefly consider trials that are currently accruing with a focus on immunotherapy agents in the adjuvant setting. PATIENT SUMMARY: Kidney cancer often recurs despite initial surgery in patients with high-risk tumors. So far, adding systemic treatments such as targeted therapies after surgery has not resulted in improved survival outcomes. Future studies that include immunotherapy after surgery to reduce the risk of recurrence in patients with high-risk disease are eagerly anticipated.

Keywords: Adjuvant therapy; Immunotherapy; Renal cell carcinoma; Targeted therapy.

Publication types

  • Review

MeSH terms

  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / surgery*
  • Chemotherapy, Adjuvant / adverse effects
  • Chemotherapy, Adjuvant / methods*
  • Combined Modality Therapy / methods
  • Humans
  • Immunotherapy / adverse effects
  • Immunotherapy / methods
  • Kidney Neoplasms / pathology
  • Molecular Targeted Therapy / adverse effects
  • Molecular Targeted Therapy / methods
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Randomized Controlled Trials as Topic