The Emerging Role of Radiation Therapy in Renal Cell Carcinoma

Christensen, Merrill J.; Hannan, Raquibul

doi:10.3390/cancers14194693

Cited by 15 publications

(12 citation statements)

References 85 publications

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“…Radiation therapy (RT), although historically was not widely used in RCC due to belief of tumor radioresistance, is also being investigated as a noninvasive adjunct to RCC TT treatment regimens. The advent of stereotactic ablative body radiation (SAbR), in which high doses of radiation can be delivered in small fractions, has demonstrated promising local control rates for primary, advanced, and metastatic RCC [4 ▪ ]. For IVC thrombi, SAbR has proven effective in small samples for symptomatic palliation and cytoreduction.…”

Section: Advances In Neoadjuvant Therapiesmentioning

confidence: 99%

“…This equates to nearly 80 000 new cases and nearly 14 000 estimated deaths in the Unites States this year [1]. For those diagnosed with renal cell carcinoma (RCC), which accounts for 80–85% of primary renal malignancies, associated inferior vena cava (IVC) thrombus is present in up to 10% of cases [2,3,4 ▪ ]. Tumor thrombus (TT) can grow intraluminally into the renal vein and craniocaudally via the IVC.…”

Section: Introductionmentioning

confidence: 99%

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Renal cell carcinoma with inferior vena cava thrombus: did we make progress in oncologic outcomes and complications?

Gold

Taylor

Margulis

2023

Current Opinion in Urology

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Purpose of reviewSurgery for renal cell carcinoma (RCC) with inferior vena cava tumor thrombus (TT) remains one of the most complex surgeries performed with high rates of associated complications and perioperative mortality. Surgical techniques and neoadjuvant therapies have an important role to play in improving outcomes. This review provides a narrative analysis of recent literature on patients with RCC and TT. Recent findingsSeveral imaging techniques are emerging that may improve diagnostic staging of tumor thrombus level. Robotic approaches to surgical resection for all thrombi levels is feasible and safe, while longer term outcomes for higher level thrombi continues to mature. Early data on neoadjuvant immunotherapy and radiotherapy have shown improvements in complication rates and intermediate term oncologic outcomes. SummaryData suggests that neoadjuvant therapies and minimally invasive techniques may improve outcomes in patients undergoing surgical resection for RCC with tumor thrombus. Larger multiinstitutional series are needed to confirm the benefit of these techniques as well as the durable long term oncologic outcomes.

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Section: Advances In Neoadjuvant Therapiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Renal cell carcinoma with inferior vena cava thrombus: did we make progress in oncologic outcomes and complications?

Gold

Taylor

Margulis

2023

Current Opinion in Urology

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“…Unfortunately, as mentioned earlier in this paper, there is a smaller percentage of RCC diagnoses that occur in the early stages of the disease when compared to other cancers, meaning that there are fewer instances when this treatment is indicated. However, when indicated SABR is a compelling option for treatment [47][48][49].…”

Section: Stereotactic Ablative Radiotherapymentioning

confidence: 99%

Treatment Options for Renal Cell Carcinoma: Mechanisms and Outcomes

Ptasienski,

Myers,

Krenn

et al. 2023

ann urol oncol

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Renal Cell Carcinoma (RCC), cancer of the tubules of the kidneys, has historically been one of the most difficult cancers to treat due to its ability to remain hidden in the body for longer than other cancers and its tendency to resist traditional forms of chemotherapy and radiation therapy. However, both traditional and nontraditional treatments of RCC have seen both significant biomedical advancements and clinical instances of use in recent years. In this review, we analyze five treatments of RCC: Nephrectomy, Immunotherapy, Anti-Angiogenesis, Chemotherapy, and Radiation Therapy, providing background on their mechanisms and clinical outcomes. Through our review of studies of clinical outcomes, we reaffirm the existing thought that nephrectomy remains the most effective treatment for RCC, while radiation therapy and chemotherapy are generally less effective and not recommended for treatment on their own. Immunotherapy and anti-angiogenic therapy have been shown to be effective treatments in the modern healthcare landscape and show great potential for the future as the techniques are better developed and optimized.

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“…Metastatic-directed therapy (MDT) was historically performed through surgical measures, but has more recently expanded to include SBRT [ 85 ]. Several studies have investigated SBRT for OM RCC [ 86 ]. A single-arm study by Tang et el.…”

Section: Role Of Radiation Therapymentioning

confidence: 99%

Treatment Landscape of Renal Cell Carcinoma

Chen,

Wang,

Panian

et al. 2023

Curr. Treat. Options in Oncol.

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Opinion StatementThe treatment landscape of renal cell carcinoma (RCC) has evolved significantly over the past three decades. Active surveillance and tumor ablation are alternatives to extirpative therapy in appropriately selected patients. Stereotactic body radiation therapy (SBRT) is an emerging noninvasive alternative to treat primary RCC tumors. The advent of immune checkpoint inhibitors (ICIs) has greatly improved the overall survival of advanced RCC, and now the ICI-based doublet (dual ICI-ICI doublet; or ICI in combination with a vascular endothelial growth factor tyrosine kinase inhibitor, ICI-TKI doublet) has become the standard frontline therapy. Based on unprecedented outcomes in the metastatic with ICIs, they are also being explored in the neoadjuvant and adjuvant setting for patients with high-risk disease. Adjuvant pembrolizumab has proven efficacy to reduce the risk of RCC recurrence after nephrectomy. Historically considered a radioresistant tumor, SBRT occupies an expanding role to treat RCC with oligometastasis or oligoprogression in combination with systemic therapy. Furthermore, SBRT is being investigated in combination with ICI-doublet in the advanced disease setting. Lastly, given the treatment paradigm is shifting to adopt ICIs at earlier disease course, the prospective studies guiding treatment sequencing in the post-ICI setting is maturing. The effort is ongoing in search of predictive biomarkers to guide optimal treatment option in RCC.

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The Emerging Role of Radiation Therapy in Renal Cell Carcinoma

Cited by 15 publications

References 85 publications

Renal cell carcinoma with inferior vena cava thrombus: did we make progress in oncologic outcomes and complications?

Renal cell carcinoma with inferior vena cava thrombus: did we make progress in oncologic outcomes and complications?

Treatment Options for Renal Cell Carcinoma: Mechanisms and Outcomes

Treatment Landscape of Renal Cell Carcinoma

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