Adjuvant therapy for renal cell carcinoma

The following article is a good review of the data from recent clinical trials of adjuvant targeted therapy for renal cell carcinoma (RCC). Adjuvant therapy is the treatment received after surgery to prevent the cancer from spreading and/or returning.

The success of targeted therapies, such as vascular endothelial growth factor (VEGF) inhibitors (sunitinib and pazopanib) or mammalian target of rapamycin (mTOR) inhibitors (everolimus), in the treatment of metastatic RCC led to interest in testing their efficacy as adjuvant therapy. Results from the first trials are now available, with other studies due to report imminently.

This review provides an overview of adjuvant targeted therapy in RCC, including interpretation of currently available conflicting data and future direction of research. The article discusses the key differences between the completed targeted therapy adjuvant trials, and highlights the importance of accurately identifying patients who are likely to benefit from adjuvant treatment. It also considers reasons why blinded independent radiology review and treatment dose may prove critical for adjuvant treatment success.

The implications of using disease-free survival as a surrogate endpoint for overall survival from the patient perspective and measurement of health benefit have recently been brought into focus and are discussed. Finally, the article discusses how the ongoing adjuvant trials with targeted therapies and checkpoint inhibitors may improve understanding and ability to prevent tumour recurrence after nephrectomy in the future.

Read the article in Annals of Oncology here (click on PDF to access the full article)

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