State-of-the-art management of renal cell carcinoma

Waleed F ouad Mourad, Janice Dutcher, Ronald D. Ennis

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

In the United States, renal cell cancer (RCC) is the third most common genitourinary tumor and the seventh most common cancer. Standard treatment of the primary tumor in RCC is complete resection by either a radical or partial nephrectomy which can be done as an open procedure or laparoscopically. Given the increasing incidence in the diagnosis of early-stage RCC and the toxicity and invasiveness associated with surgery, less invasive options (eg, radiofrequency ablation) have been used recently as an alternative. Although conventional radiotherapy plays a role in the palliative setting, its role is otherwise limited. This is partly because of the in vitro and clinical data showing that RCC is relatively radioresistant to radiotherapy. The advances in immobilization and image guidance have led several investigators to consider stereotactic techniques to overcome this resistance with impressive results in the metastatic setting. Recent retrospective and prospective phase II trials of RCC stereotactic body radiotherapy have shown excellent local controls up to 90% to 98%. Given these results and the noninvasive nature of stereotactic body radiotherapy this modality should be further evaluated as a treatment of choice for the primary RCC tumor. Although RCC is also resistant of conventional chemotherapy agents, exciting recent advances have emerged in the treatment of systemic disease with the development of targeted agents in addition to immunotherapy-based treatments. In the current critical review we discuss these emerging trends in localized and systemic treatment as well as possible interesting combinations of the 2 modalities.

Original languageEnglish (US)
Pages (from-to)498-505
Number of pages8
JournalAmerican Journal of Clinical Oncology
Volume37
Issue number5
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

Fingerprint

Renal Cell Carcinoma
Radiosurgery
Neoplasms
Radiotherapy
Stereotaxic Techniques
Therapeutics
Nephrectomy
Immobilization
Immunotherapy
Research Personnel
Drug Therapy
Incidence

Keywords

  • Chemotherapy
  • Immunotherapy
  • Radiotherapy (RT)
  • Renal cell carcinoma (RCC)
  • Stereotactic body radiosurgery (SBRT)
  • Targeted therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

State-of-the-art management of renal cell carcinoma. / Mourad, Waleed F ouad; Dutcher, Janice; Ennis, Ronald D.

In: American Journal of Clinical Oncology, Vol. 37, No. 5, 01.10.2014, p. 498-505.

Research output: Contribution to journalArticle

Mourad, Waleed F ouad ; Dutcher, Janice ; Ennis, Ronald D. / State-of-the-art management of renal cell carcinoma. In: American Journal of Clinical Oncology. 2014 ; Vol. 37, No. 5. pp. 498-505.
@article{00e188484a0749a98ef92b960b5837fc,
title = "State-of-the-art management of renal cell carcinoma",
abstract = "In the United States, renal cell cancer (RCC) is the third most common genitourinary tumor and the seventh most common cancer. Standard treatment of the primary tumor in RCC is complete resection by either a radical or partial nephrectomy which can be done as an open procedure or laparoscopically. Given the increasing incidence in the diagnosis of early-stage RCC and the toxicity and invasiveness associated with surgery, less invasive options (eg, radiofrequency ablation) have been used recently as an alternative. Although conventional radiotherapy plays a role in the palliative setting, its role is otherwise limited. This is partly because of the in vitro and clinical data showing that RCC is relatively radioresistant to radiotherapy. The advances in immobilization and image guidance have led several investigators to consider stereotactic techniques to overcome this resistance with impressive results in the metastatic setting. Recent retrospective and prospective phase II trials of RCC stereotactic body radiotherapy have shown excellent local controls up to 90{\%} to 98{\%}. Given these results and the noninvasive nature of stereotactic body radiotherapy this modality should be further evaluated as a treatment of choice for the primary RCC tumor. Although RCC is also resistant of conventional chemotherapy agents, exciting recent advances have emerged in the treatment of systemic disease with the development of targeted agents in addition to immunotherapy-based treatments. In the current critical review we discuss these emerging trends in localized and systemic treatment as well as possible interesting combinations of the 2 modalities.",
keywords = "Chemotherapy, Immunotherapy, Radiotherapy (RT), Renal cell carcinoma (RCC), Stereotactic body radiosurgery (SBRT), Targeted therapy",
author = "Mourad, {Waleed F ouad} and Janice Dutcher and Ennis, {Ronald D.}",
year = "2014",
month = "10",
day = "1",
doi = "10.1097/COC.0b013e31825d5522",
language = "English (US)",
volume = "37",
pages = "498--505",
journal = "American Journal of Clinical Oncology",
issn = "0277-3732",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - State-of-the-art management of renal cell carcinoma

AU - Mourad, Waleed F ouad

AU - Dutcher, Janice

AU - Ennis, Ronald D.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - In the United States, renal cell cancer (RCC) is the third most common genitourinary tumor and the seventh most common cancer. Standard treatment of the primary tumor in RCC is complete resection by either a radical or partial nephrectomy which can be done as an open procedure or laparoscopically. Given the increasing incidence in the diagnosis of early-stage RCC and the toxicity and invasiveness associated with surgery, less invasive options (eg, radiofrequency ablation) have been used recently as an alternative. Although conventional radiotherapy plays a role in the palliative setting, its role is otherwise limited. This is partly because of the in vitro and clinical data showing that RCC is relatively radioresistant to radiotherapy. The advances in immobilization and image guidance have led several investigators to consider stereotactic techniques to overcome this resistance with impressive results in the metastatic setting. Recent retrospective and prospective phase II trials of RCC stereotactic body radiotherapy have shown excellent local controls up to 90% to 98%. Given these results and the noninvasive nature of stereotactic body radiotherapy this modality should be further evaluated as a treatment of choice for the primary RCC tumor. Although RCC is also resistant of conventional chemotherapy agents, exciting recent advances have emerged in the treatment of systemic disease with the development of targeted agents in addition to immunotherapy-based treatments. In the current critical review we discuss these emerging trends in localized and systemic treatment as well as possible interesting combinations of the 2 modalities.

AB - In the United States, renal cell cancer (RCC) is the third most common genitourinary tumor and the seventh most common cancer. Standard treatment of the primary tumor in RCC is complete resection by either a radical or partial nephrectomy which can be done as an open procedure or laparoscopically. Given the increasing incidence in the diagnosis of early-stage RCC and the toxicity and invasiveness associated with surgery, less invasive options (eg, radiofrequency ablation) have been used recently as an alternative. Although conventional radiotherapy plays a role in the palliative setting, its role is otherwise limited. This is partly because of the in vitro and clinical data showing that RCC is relatively radioresistant to radiotherapy. The advances in immobilization and image guidance have led several investigators to consider stereotactic techniques to overcome this resistance with impressive results in the metastatic setting. Recent retrospective and prospective phase II trials of RCC stereotactic body radiotherapy have shown excellent local controls up to 90% to 98%. Given these results and the noninvasive nature of stereotactic body radiotherapy this modality should be further evaluated as a treatment of choice for the primary RCC tumor. Although RCC is also resistant of conventional chemotherapy agents, exciting recent advances have emerged in the treatment of systemic disease with the development of targeted agents in addition to immunotherapy-based treatments. In the current critical review we discuss these emerging trends in localized and systemic treatment as well as possible interesting combinations of the 2 modalities.

KW - Chemotherapy

KW - Immunotherapy

KW - Radiotherapy (RT)

KW - Renal cell carcinoma (RCC)

KW - Stereotactic body radiosurgery (SBRT)

KW - Targeted therapy

UR - http://www.scopus.com/inward/record.url?scp=84921821613&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84921821613&partnerID=8YFLogxK

U2 - 10.1097/COC.0b013e31825d5522

DO - 10.1097/COC.0b013e31825d5522

M3 - Article

VL - 37

SP - 498

EP - 505

JO - American Journal of Clinical Oncology

JF - American Journal of Clinical Oncology

SN - 0277-3732

IS - 5

ER -