Neoadjuvant and adjuvant strategies in renal cell carcinoma: more questions than answers.

Details

Serval ID
serval:BIB_73800E4C3E9E
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Neoadjuvant and adjuvant strategies in renal cell carcinoma: more questions than answers.
Journal
Anti-cancer drugs
Author(s)
Homicsko K., Berthold D.R.
ISSN
1473-5741 (Electronic)
ISSN-L
0959-4973
Publication state
Published
Issued date
01/2011
Peer-reviewed
Oui
Volume
22 Suppl 1
Pages
S4-8
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Abstract
The current standard treatment for early stage (I-III) renal cell cancer (RCC) is surgery. While the prognosis of stage I tumors is excellent, stage II and particularly stage III have a high risk of relapse. The adjuvant treatment of patients with RCC remains an area of investigation, with patient selection being a key aspect. There are currently two prognostic nomograms to establish the risk of relapse in patients with resected RCC. The results of earlier studies of adjuvant therapy, including the use chemotherapy and/or immunotherapy after nephrectomy have failed to show any benefit in the outcome of patients at risk of developing local recurrence or distant metastases. Two recent phase III trials with vaccines (autologous tumor cell vaccine and autologous tumor-derived heat shock protein peptide complex-96) have shown promising, albeit still preliminary, results. In the metastatic RCC setting, recent advances in the molecular understanding of oncogenic pathways have led to the development of new therapeutic strategies with the use of targeted therapies in the adjuvant setting. Neoadjuvant treatment is another treatment modality currently being evaluated for patients with early disease and in patients with metastatic RCC with inoperable primary tumors. The questions that remain unanswered include activity of these agents in early stages of the disease, patient selection, optimal start time of the adjuvant treatment, and finally, the optimal length of treatment.

Keywords
Adjuvants, Immunologic/therapeutic use, Antineoplastic Agents/therapeutic use, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Cancer Vaccines/administration & dosage, Cancer Vaccines/therapeutic use, Carcinoma, Renal Cell/drug therapy, Carcinoma, Renal Cell/surgery, Chemotherapy, Adjuvant, Clinical Trials, Phase III as Topic, Combined Modality Therapy, Humans, Immunotherapy, Kidney Neoplasms/drug therapy, Kidney Neoplasms/surgery, Neoadjuvant Therapy, Neoplasm Staging, Nephrectomy, Prognosis
Pubmed
Create date
22/02/2011 11:09
Last modification date
20/08/2019 14:31
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