Multimodal treatment of advanced renal cancer in 2017

ABSTRACT

Introduction: in the last decades, the treatment of renal cell carcinoma has become more complex due to the introduction of novel systemic agents and the improvement of the loco-regional therapies that prolong survival maintaining a good quality of life.

Areas covered: in this review, we summarize the currently available local and systemic treatment options, their indications and their hypothetical role in the management of advanced renal cell carcinoma, highlighting the need of multimodality treatment paradigms within interdisciplinary decision-making.

Expert commentary: in early disease, radical or partial nephrectomy remains the standard of care, but innovative ablation techniques, including radiofrequency ablation, microwave ablation, cryoablation and so on, may represent an alternative option of treatment for small renal lesions in unfit patients who cannot undergo surgery. In metastatic setting, it is imperative a multidisciplinary team approach to select patients for a cytoreductive nephrectomy, metastasectomy, and/or systemic treatment, aiming to the optimization of the treatment strategy.

KEYWORDS:

• Ablative therapies
• cytoreductive nephrectomy
• immunotherapy
• metastasectomy
• multidisciplinary care
• radiotherapy
• renal cell carcinoma
• targeted therapy

Declaration of Interest

G Procopio reports receiving fees for serving on advisory boards from Bayer, Bristol-Myers-Squibb, Ipsen, Janssen and Novartis and lecture fees from Astellas and Pfizer. E Verzoni reports receiving fees for serving on advisory boards from Pfizer, Janssen and Novartis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. A reviewer on this manuscript has disclosed being a paid speaker for: Amgen, Bayer, Eisai, GSK, Novartis, Pfizer, Roche and sitting on the Advisory board role: Pfizer and receiving travel support: Amgen, Astellas, Bayer, GSK, Novartis, Pfizer, Roche, Takeda.

Additional information

Funding

This paper was not funded.