Management of oligometastatic and oligoprogressive renal cell carcinoma: state of the art and future directions.
Expert Rev Anticancer Ther
; 20(6): 491-501, 2020 06.
Article
en En
| MEDLINE
| ID: mdl-32479120
ABSTRACT
INTRODUCTION:
The aim of this paper was to perform a narrative review of the literature on the available approaches in the treatment of two emerging subpopulations of metastatic renal cell carcinoma (mRCC) patients the oligometastatic disease (less than 5 metastasis) and the oligoprogressive disease, defined as worsening in maximum 3-5 sites while all other tumor sites are controlled by systemic therapy. AREAS COVERED We explore all possible approaches in these settings of patients the role of local therapies, considering both surgical metastasectomy and/or ablative techniques, the efficacy of systemic therapies and the rationale behind active surveillance. We also discuss ongoing clinical trials in these settings. EXPERT OPINION Two different strategies are emerging as the most promising for the approach to the oligometastatic/oligoprogressive mRCC patient (1) the use of immunocheckpoint inhibitors following metastasectomy; (2) the use of stereotactic radiotherapy alone or combined with immunotherapy for oligometastatic disease. The lack of validated biomarkers of response in these mRCC patient subpopulations is opening the way to the employment of novel technologies. Among them, the use of artificial intelligence seems to be the candidate to contribute to precision oncology in patients with mRCC.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_kidney_renal_pelvis_ureter_cancer
Asunto principal:
Carcinoma de Células Renales
/
Neoplasias Renales
Límite:
Humans
Idioma:
En
Revista:
Expert Rev Anticancer Ther
Asunto de la revista:
NEOPLASIAS
/
TERAPEUTICA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Italia