Management of metastatic renal cell carcinoma patients with poor-risk features: current status and future perspectives

Abstract

With seven agents approved for renal cell carcinoma within the past few years, there has undoubtedly been progress in treating this disease. However, patients with poor-risk features remain a challenging and difficult-to-treat population, with the mTOR inhibitor, temsirolimus, the only agent approved in the first-line setting. Phase III trial data are still lacking VEGF-pathway inhibitors in patients with poor prognostic features.

Poor-risk patients need to be considered as a heterogeneous population. Further understanding of biomarkers can lead to a better selection of patients who may benefit the most from treatment and improvements in prognosis. The presence of poor Karnofsky scores and liver or CNS disease may affect the outcome of these patients much more than other identified factors. This consideration may provide the rationale to further stratify poor-risk patients further subgroups destined to receive either cure or palliation.

Keywords::

• mRCC
• poor risk
• risk stratification
• tailored therapy
• targeted therapies

Financial & competing interests disclosure

This work was supported in part by grants from the Italian Association for Cancer Research (AIRC, to M Milella); V Vaccaro is an AIRC fellow. 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.

Editorial assistance for the preparation of this manuscript was provided by Luca Giacomelli, PhD, on behalf of Content Ed Net; this assistance was funded by Pfizer.