Renal Cell Carcinoma: A Complex Therapeutic Challenge in the Elderly

Abstract

An increase in age and the occurrence of renal cell carcinoma have been positively correlated. A strict therapeutic protocol for early diagnosis, screening, prevention, and population awareness needs to be wellestablished as a rationale to approach the morbidity at a treatment-eligible phase in the aged. Genetic predisposition appears to have a minor role in the disease pathology. Imaging modalities, providing highresolution images of the tumor, have undoubtedly benefitted the diseased subset in aiding the diagnosis, however, a preliminary guideline protocol for its early implication in concordance with the initial symptoms needs to be adopted. Burdening of the geriatric age group by concomitant co-morbidities further deteriorates the devastating effects of the primary tumor, which, in total, appear to evolve as a final, complex stage of the illness in the majority, leading to an eventual high mortality rate. Despite being a challenging task for managing the tumor, age should not be considered the sole treatment barrier for approaching the disease.

Current Status of Tivozanib in the Treatment of Patients With Advanced Renal Cell Carcinoma

“…These data introduce tivozanib as a convenient new option for clinicians in the advanced treatment setting since it is a relatively easy medication to handle. Real-world patients who are receiving subsequent lines of therapy are frequently frail with lower performance status and cannot easily tolerate VEGFR TKIs [ 9 ]. Dose reductions and interruptions of VEGFR TKIs have been associated with worse clinical outcomes [ 8 , 21 , 22 ].…”

“…Unfortunately, the use of VEGFR TKIs is limited by their considerable toxicity [7,8]. Real-world patients with metastatic kidney cancer, especially after several lines of treatment, are often frail with poor performance status, and they need to take TKIs for long periods of time [9]. As a result, dose reductions, treatment interruptions, or even treatment discontinuation occur frequently [7][8][9].…”

“…Real-world patients with metastatic kidney cancer, especially after several lines of treatment, are often frail with poor performance status, and they need to take TKIs for long periods of time [9]. As a result, dose reductions, treatment interruptions, or even treatment discontinuation occur frequently [7][8][9]. Therefore, the potential introduction of novel VEGFR TKIs into clinical practice with similar efficacy and a more favorable toxicity profile would constitute a major advancement.…”

LncRNA LINC00667 gets involved in clear cell renal cell carcinoma development and chemoresistance by regulating the miR-143-3p/ZEB1 axis

“…At this stage, surgical resection remains the mainstay of treatment for ccRCC, while the relapse and metastasis rate reach as high as 30-35% of patients who undergo nephrectomy [ 3 ]. Achieving early diagnosis and effective therapy of ccRCC has become the main goal of ccRCC management [ 4 ]. Molecular markers, such as CAIX, PTEN, and CXCR4, have been found to show altered gene expression, gene mutations, and methylation status, and they provide more treatment selections in ccRCC [ 5 ], suggesting that investigating novel biomarkers for the early diagnosis, individualized treatment, and prognostic determination of ccRCC is necessary.…”

Comparative Analysis for the Distinction of Chromophobe Renal Cell Carcinoma from Renal Oncocytoma in Computed Tomography Imaging Using Machine Learning Radiomics Analysis

“…Renal Cell Carcinoma (RCC) has the highest mortality rates of all genitourinary malignancies, and its prevalence has been gradually increasing [ 1 , 2 , 3 ]. In recent years, there has been an upsurge in the number of cases of RCC all over the world [ 4 , 5 , 6 , 7 , 8 ].…”