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Adjuvant Therapy of Renal Cell Carcinoma
Affiliation:1. Harvard TH Chan School of Public Health, Harvard University, Cambridge, MA, USA;2. Harvard Global Equity Initiative, Harvard University, Cambridge, MA, USA;3. Harvard Medical School, Harvard University, Cambridge, MA, USA;4. Princess Margaret Cancer Centre, Toronto, ON, Canada;5. TECHNA Institute, University Health Network, Toronto, ON, Canada;6. Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada;7. Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia;8. International Agency for Research on Cancer, Lyon, France;9. Department of Radiation Oncology, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany;10. National Cancer Institute, US National Institutes of Health, Bethesda, MD, USA;11. Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen''s University, Kingston, ON, Canada;12. Ghent University Hospital, Ghent, Belgium;13. Ghent University, Ghent, Belgium;14. International Atomic Energy Agency, Vienna, Austria;15. Department of Medical Biophysics, Western University, London, ON, Canada;p. Global Task Force on Radiotherapy for Cancer Control, Toronto, ON, Canada;1. Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada;2. Sainte-Justine Hospital Research Center, Montreal, QC, Canada;3. Institut Català d''Oncologia (ICO) – Catalan Institute of Oncology, IDIBELL, L''Hospitalet de Llobregat, Barcelona, Spain;4. CIBER Epidemiología y Salud Pública, CIBERESP, Barcelona, Spain;5. Unit of Cancer Epidemiology, Scientific Institute of Public Health, Brussels, Belgium;6. University of Antwerp, Antwerp, Belgium;1. Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom;2. West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom;3. Cancer Research UK Beatson Institute, Glasgow, United Kingdom;4. Department of Pharmacological Faculty, Université Grenoble Alpes, Saint-Martin-d’Heres, France;5. Department of Biochemistry and Structural Biology, University of Texas Health San Antonio, San Antonio, Texas;6. Medical Research Council Institute of Genetics and Molecular Medicine, Edinburgh Cancer Research UK Centre, University of Edinburgh, Edinburgh, United Kingdom;7. Cold Spring Harbor Laboratory, Cold Spring Harbor, New York;8. Lustgarten Foundation Pancreatic Cancer Research Laboratory, Cold Spring Harbor, New York;9. Stratified Medicine Scotland, Queen Elizabeth University Hospital, Glasgow, United Kingdom;10. College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow, United Kingdom;11. Department of Pathology, Queen Elizabeth University Hospital, Glasgow, United Kingdom;12. Greater Glasgow and Clyde Bio-repository, Pathology Department, Queen Elizabeth University Hospital, Glasgow, United Kingdom;13. Cancer Research UK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom;14. Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan;15. Barts Cancer Institute, Queen Mary University of London, London, United Kingdom;16. Bioscience, Oncology, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Cambridge, United Kingdom;17. Department of Surgery, Universitätsklinikum Erlangen, Erlangen, Germany;18. Pancreatic Cancer Action Network, Manhattan Beach, California;19. Glasgow Precision Oncology Laboratory, Glasgow, United Kingdom;20. Australian Pancreas Genome, Darlinghurst, Australia;21. The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia;22. Epigenetics Unit, Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom;23. Sanger Institute, Wellcome Genome Campus, Cambridge, United Kingdom;24. Mayo Clinic, Rochester, Minnesota;25. University of California–San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California;26. Pancreatic Cancer Center, Perlmutter Cancer Center, New York University Langone Health, New York, New York;27. Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine and Science, Jacksonville, Florida;28. South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, Australia;1. Molecular Therapy of Virus-Associated Cancers, German Cancer Research Center (DKFZ), D-69120 Heidelberg, Germany;1. Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Cancer Research Centre, Wilmslow Rd, Manchester, M20 4GJ, UK;2. Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, UK;3. Divisions of Structural Biology & Cancer Biology, The Institute of Cancer Research (ICR), London, SW7 3RP, UK
Abstract:
Metastatic renal cell carcinoma (RCC) has a highly variable natural history and carries a dismal prognosis. Unlike many other tumors, RCC is generally unresponsive to cytotoxic, hormonal, and radiation adjuvant therapies after cytoreductive surgery. Different modalities of treatment have been tried and tested with modest success. Until recently, only immunotherapies such as interleukin-2 and interferon- α have been shown to provide a response, albeit in a minority of patients and often with severe treatment-associated toxicities. Other adjuvant therapies, such as active specific immunotherapy with Bacillus Calmette-Guerin and autologous renal tumor cell vaccines, have not provided alternative solutions. Recent approaches include heatshock protein peptide complex 96 vaccine and cG250 monoclonal antibody therapy. Novel targeted therapies have been developed using our knowledge of the molecular genetics that belie RCC. This culminated in sorafenib and sunitinib, the first Food and Drug Administration– approved drugs for RCC in more than a decade in the United States. The future will see further trials being carried out in the development of targeted therapies with emphasis placed on patient selection. Staging systems will need to be updated to integrate molecular biomarkers, which could potentially act not just as diagnostic and prognostic predictors, but also as tools for appropriate patient selection for treatment. In the future, this could potentially lead us to our ultimate goal of personalized medicine.
Keywords:
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