The Promise of Neoadjuvant and Adjuvant Therapies for Renal Cancer - 21/03/23

Doi : 10.1016/j.ucl.2023.01.011

Jeffrey J. Leow, MBBS, MPH, MRCS, FAMS(Urology) ^a, Shagnik Ray, MD ^b, Shawn Dason, MD ^b, Eric A. Singer, MD, MA, MS ^b, Steven L. Chang, MD, MS ^c,^⁎
^a Department of Urology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Annex 1-L04-Uro, Singapore 308433, Singapore
^b Division of Urologic Oncology, The Ohio State University Comprehensive Cancer Center, 915 Olentangy River Road, Suite 3100, Columbus, OH 43212, USA
^c Division of Urology, Brigham and Women’s Hospital, 45 Francis Street, Suite ASBII-3, Boston, MA 02115, USA

^∗Corresponding author.

Résumé

Because metachronous metastatic disease will develop in 20% to 40% of patients with presumed localized renal cell carcinoma (RCC) treated surgically, research is focused on neoadjuvant and adjuvant systemic therapy, to improve disease-free and overall survival. Neoadjuvant therapies trialed include anti–vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor (TKI) agents, or combination therapies (immunotherapy with TKI), and aim to improve resectability of locoregional RCC. Adjuvant therapies trialed include cytokines, anti-VEGF TKI agents, or immunotherapy. These therapeutics can facilitate the surgical extirpation of the primary kidney tumor in the neoadjuvant setting and improve disease-free survival in the adjuvant setting.

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Keywords : Renal cancer, Kidney neoplasms, Radical nephrectomy, Systemic therapy, Neoadjuvant therapy, Adjuvant therapy, Immunotherapy, Targeted therapy