[New anti-angiogenic strategies in the management of kidney cancer]. / Nouvelles stratégies anti-angiogéniques dans la prise en charge du cancer du rein.

ABSTRACT

INTRODUCTION: The aim of this study was to clarify the current role of adjuvant and neo-adjuvant in the treatment of kidney cancer. MATERIALS AND METHODS: The data were explored in Medline (http//www.ncbi.nlm.nih.gov) using the following MeSH terms or combinations of these keywords "cancer", "rein", "kidney", "adjuvant", "neoadjuvant", "antiangiogenique", "antiangiogenic" and selecting the items produced in their methodology, their relevance to the theme explored and their date of publication. RESULTS: Thirty-two English and French items published between 2001 and 2011 were selected five studies of evidence level 1, nine level 2 studies, nine level 4 studies, five studies at level 5 and four literature reviews. The cytoreductive nephrectomy as first-line treatment of locally advanced or metastatic kidney cancer is now controversial with the advent of new targeted anti-angiogenic therapies. In neoadjuvant setting, these treatments showed a moderate decrease in tumor volume and rarely improved resectability. In adjuvant setting, their place has yet to be specified and several trials are currently underway. CONCLUSION: Recent years have seen the anti-angiogenic therapeutic strategies upset in locally advanced and metastatic renal cancer. The development of clinical trials and research protocols will allow us to determine in the near future the optimal therapeutic sequences.