Adjuvant therapy for renal cell carcinoma: A systematic review of current landscape and future directions

BÖLEK H., ÜRÜN Y.

Critical Reviews in Oncology/Hematology, vol.192, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Review
  • Volume: 192
  • Publication Date: 2023
  • Doi Number: 10.1016/j.critrevonc.2023.104144
  • Journal Name: Critical Reviews in Oncology/Hematology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, MEDLINE
  • Keywords: Adjuvant, Renal cell carcinoma, Tyrosine kinase inhibitor, immune checkpoint inhibitor
  • Ankara University Affiliated: Yes

Abstract

The advent of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) has been transformative for the treatment of advanced renal cell carcinoma (RCC). Their efficacy post-surgical resection remains a contentious point. Various phase 3 RCTs have assessed their potency. Amongst evaluated agents, sunitinib and pembrolizumab have demonstrated notable disease-free survival benefits. Sunitinib's potential is diminished due to absence of clear overall survival (OS) benefits and side-effect profile. Pembrolizumab shows better tolerance, conclusive OS data are forthcoming. This scenario underscores the pressing need for advanced risk stratification methods and discovery of novel biomarkers. Existing strategies, largely pre-dating TKI and ICI therapeutic era, lack sufficient accuracy in predicting relapse-risk. Our review offers a comprehensive analysis of key phase 3 RCTs, focusing on TKIs, mTOR-inhibitors, and ICIs for adjuvant RCC treatment. The intent is to shed light on the intricate landscape of RCC treatment, guiding future research directions for optimizing patient outcomes.