Therapies in Refractory Metastatic Renal Cell Carcinoma

As the therapeutic landscape for metastatic clear cell renal cell carcinoma (mccRCC) expands to include vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR TKIs) and immunotherapies, new challenges are in place for evaluating and treating refractory disease. Assessing and m...

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Main Authors: Stephanie Berg, Martin Angel, Kathryn E. Beckermann, Frede Donskov, Chung-Han Lee, Pavlos Msaouel, Rana R. McKay, Tian Zhang
Format: Article
Language:English
Published: MDPI AG 2022-11-01
Series:Société Internationale d’Urologie Journal
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Online Access:https://siuj.org/index.php/siuj/article/download/223/163
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author Stephanie Berg
Martin Angel
Kathryn E. Beckermann
Frede Donskov
Chung-Han Lee
Pavlos Msaouel
Rana R. McKay
Tian Zhang
author_facet Stephanie Berg
Martin Angel
Kathryn E. Beckermann
Frede Donskov
Chung-Han Lee
Pavlos Msaouel
Rana R. McKay
Tian Zhang
author_sort Stephanie Berg
collection DOAJ
description As the therapeutic landscape for metastatic clear cell renal cell carcinoma (mccRCC) expands to include vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR TKIs) and immunotherapies, new challenges are in place for evaluating and treating refractory disease. Assessing and managing refractory disease has several elements: (1) the mechanism(s) of front-line treatment, (2) timing of progressive disease, (3) rapidity and sites of progressing disease, (4) use of adjuvant therapy, and (5) incorporation of surgical and radiation techniques. These variables all have distinct impact on the biology of refractory or resistant mccRCC. A better understanding of the essential mechanisms of both primary and secondary immunotherapy resistance will inform biomarker development and therapeutic strategies in the refractory setting. This paper addresses the current understanding of treatment sequencing in refractory mccRCC, focusing on treatment options with prospective clinical trial data, considers refractory mccRCC after adjuvant immunotherapy, and incorporates radiation or surgical resection for oligoprogressive disease.
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series Société Internationale d’Urologie Journal
spelling doaj-art-a5cbce987c764e8f97ba273c98c2ab8f2025-08-20T02:00:41ZengMDPI AGSociété Internationale d’Urologie Journal2563-64992022-11-013647848410.48083/KGTQ6832Therapies in Refractory Metastatic Renal Cell CarcinomaStephanie BergMartin AngelKathryn E. BeckermannFrede DonskovChung-Han LeePavlos MsaouelRana R. McKayTian ZhangAs the therapeutic landscape for metastatic clear cell renal cell carcinoma (mccRCC) expands to include vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR TKIs) and immunotherapies, new challenges are in place for evaluating and treating refractory disease. Assessing and managing refractory disease has several elements: (1) the mechanism(s) of front-line treatment, (2) timing of progressive disease, (3) rapidity and sites of progressing disease, (4) use of adjuvant therapy, and (5) incorporation of surgical and radiation techniques. These variables all have distinct impact on the biology of refractory or resistant mccRCC. A better understanding of the essential mechanisms of both primary and secondary immunotherapy resistance will inform biomarker development and therapeutic strategies in the refractory setting. This paper addresses the current understanding of treatment sequencing in refractory mccRCC, focusing on treatment options with prospective clinical trial data, considers refractory mccRCC after adjuvant immunotherapy, and incorporates radiation or surgical resection for oligoprogressive disease.https://siuj.org/index.php/siuj/article/download/223/163refractory metastatic clear cell renal cell carcinomavascular endothelial growth factor receptor tyrosine kinase inhibitorimmunotherapy resistance
spellingShingle Stephanie Berg
Martin Angel
Kathryn E. Beckermann
Frede Donskov
Chung-Han Lee
Pavlos Msaouel
Rana R. McKay
Tian Zhang
Therapies in Refractory Metastatic Renal Cell Carcinoma
Société Internationale d’Urologie Journal
refractory metastatic clear cell renal cell carcinoma
vascular endothelial growth factor receptor tyrosine kinase inhibitor
immunotherapy resistance
title Therapies in Refractory Metastatic Renal Cell Carcinoma
title_full Therapies in Refractory Metastatic Renal Cell Carcinoma
title_fullStr Therapies in Refractory Metastatic Renal Cell Carcinoma
title_full_unstemmed Therapies in Refractory Metastatic Renal Cell Carcinoma
title_short Therapies in Refractory Metastatic Renal Cell Carcinoma
title_sort therapies in refractory metastatic renal cell carcinoma
topic refractory metastatic clear cell renal cell carcinoma
vascular endothelial growth factor receptor tyrosine kinase inhibitor
immunotherapy resistance
url https://siuj.org/index.php/siuj/article/download/223/163
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AT pavlosmsaouel therapiesinrefractorymetastaticrenalcellcarcinoma
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