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The therapeutic options for advanced or metastatic renal cell carcinoma (mRCC) have drastically evolved over the past 20 years. High-dose interleukin-2 (HD IL-2), which led to durable complete responses in a small fraction of patients by activating the interleukin-2 (IL-2) pathway, faded in popularity with the advent of oral tyrosine kinase inhibitors directed against the VEGF pathway (VEGFR-TKI) showing better tolerability, wider applicability, higher objective response rates, and longer progression-free survival than HD IL-2. More recently, new insights on how to more efficiently harness the immune system led to the development of immune checkpoint inhibitor (ICI) therapies, which rapidly became an integral component of mRCC treatment. The recently approved regimen combining the PD-1 inhibitor, nivolumab, and the CTLA-4 inhibitor, ipilimumab, and the recently approved regimens combining the oral VEGFR-TKI, axitinib, with the PD-1 inhibitor, pembrolizumab, or the PD-L1 inhibitor, avelumab, were shown to yield improved outcomes compared with sunitinib, the VEGFR-TKI that was used as a comparator. The present review discusses the evidence behind the treatment approvals for mRCC and provides an overview of the current therapeutic landscape. We evaluated the results of randomized clinical trials for mRCC based on the effect size differences between treatments on relative scales and used second-generation p-values as a descriptive summary of the statistical evidence.
This article was published in the following journal.
Name: Cancer treatment and research communications
Treatment options for clear-cell metastatic renal cell carcinoma (mRCC) have increased significantly. Clinical practice guidelines aim to aid with decision-making about treatment selection through evi...
Clear cell renal cell carcinoma (ccRCC) is the most common kidney tumor. If feasible, metastasectomy is preferably indicated in metastatic disease.
There is evidence that cytoreductive nephrectomy (CN) may be beneficial in metastatic renal cell carcinoma (mRCC). This has been studied predominantly in clear-cell RCC, with more limited data on the ...
The aim of this study was to determine the valuable magnetic resonance imaging (MRI) features of sinonasal metastatic clear-cell renal cell carcinoma (cc-RCC), especially focusing on its dynamic-enhan...
Until recently, a dichotomy existed in the front-line approach of metastatic clear-cell renal cell carcinoma (mRCC). Specifically, patients received either targeted therapy or immunotherapy. Targeted ...
Study MO39939 is an open-label, single-arm, multicenter trial in patients with unresectable, locally-advanced or metastatic, clear or non-clear cell renal cell carcinoma (RCC) who have not...
The purpose of the study is to compare the clinical benefit, as measured by duration of overall survival, of Nivolumab vs. Everolimus in subjects with advanced or metastatic clear-cell ren...
This study will evaluate the use of nivolumab before surgery in patients with high-risk clear cell renal cell carcinoma who are eligible for nephrectomy. Nivolumab is an antibody that may ...
This will be a prospective, open-label, randomized multicenter phase-II study to evaluate progression free survival (PFS) in patients with locally advanced or metastatic non-clear cell ren...
Clear cell renal cell carcinoma is diagnosed by imaging, sometimes associated with biopsy. This diagnosis is expensive, invasive and sometimes late. The development of a simple biological ...
A heterogeneous group of sporadic or hereditary carcinoma derived from cells of the KIDNEYS. There are several subtypes including the clear cells, the papillary, the chromophobe, the collecting duct, the spindle cells (sarcomatoid), or mixed cell-type carcinoma.
An acridine derivative formerly widely used as an antimalarial but superseded by chloroquine in recent years. It has also been used as an anthelmintic and in the treatment of giardiasis and malignant effusions. It is used in cell biological experiments as an inhibitor of phospholipase A2.
A rare tumor of the female genital tract, most often the ovary, formerly considered to be derived from mesonephric rests. Two varieties are recognized: (1) clear cell carcinoma, so called because of its histologic resemblance to renal cell carcinoma, and now considered to be of muellerian duct derivation and (2) an embryonal tumor (called also ENDODERMAL SINUS TUMOR and yolk sac tumor), occurring chiefly in children. The latter variety may also arise in the testis. (Dorland, 27th ed)
A sarcoma of young, often female, adults of the lower extremities and acral regions, intimately bound to tendons as circumscribed but unencapsulated melanin-bearing tumors of neuroectodermal origin. An ultrastructural finding simulates flattened and curved barrel staves, corresponding to the internal structures of premelanosomes. There is a 45-60% mortality in clear cell sarcoma. (Segen, Dictionary of Modern Medicine, 1992)
A carbonic anhydrase and transmembrane protein that consists of an N-terminal PROTEOGLYCAN-like domain, a catalytic region, a single-pass transmembrane domain, and a short intracellular tail. It functions as a dimer and is expressed primarily by cells of the GASTROINTESTINAL TRACT; BILE DUCT EPITHELIUM; and GALL BLADDER. It is expressed at high levels in many solid tumors, especially CLEAR CELL RENAL CARCINOMA, in response to CELL HYPOXIA.
Renal Cell Carcinoma
Renal cell cancer (renal adenocarcinoma or hypernephroma) is the most common type of kidney cancer in adults. More than 8 in every 10 (80%) kidney cancers diagnosed in the UK are this type. In renal cell cancer the cancerous cells start in the lini...
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