Neoadjuvant therapy for localized and locally advanced renal cell carcinoma

Neoadjuvant Targeted Molecular Therapy in the setting of localized and locally advanced renal cell carcinoma has emerged as a strategy to render primary renal tumors amenable to planned surgical resection in settings where radical resection or nephron-sparing surgery was not thought to be safe or feasible. Presurgical tumor reduction has been demonstrated in a number of studies including a recently published randomized double-blind placebo-controlled study, and an expanding body of literature suggests benefit in select patients. Nonetheless, most reports are small phase II clinical trials or retrospective reports. Thus, large randomized clinical trial data are not present to support this approach, and guidelines for use of presurgical therapy have not been promulgated. The advent of immunomodulation through checkpoint inhibition represents an exciting horizon for neoadjuvant strategies. This article reviews the current status and future prospects of neoadjuvant therapy in nonmetastatic renal cell carcinoma.

Urologic oncology. 2017 Aug 09 [Epub ahead of print]

Ahmet Bindayi, Zachary A Hamilton, Michelle L McDonald, Kendrick Yim, Frederick Millard, Rana R McKay, Steven C Campbell, Brian I Rini, Ithaar H Derweesh

Department of Urology, Moores UCSD Cancer Center, University of California San Diego School of Medicine, La Jolla, CA., Department of Internal Medicine, Moores UCSD Cancer Center, University of California San Diego School of Medicine, La Jolla, CA., Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Lerner College of Medicine, Cleveland, OH., Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Center, Lerner College of Medicine, Cleveland, OH., Department of Urology, Moores UCSD Cancer Center, University of California San Diego School of Medicine, La Jolla, CA. Electronic address: .

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