Recurrence rates as high as 65% after nephrectomy for localized kidney cancer clearly highlight the need for active adjuvant therapies aimed at reducing this risk of relapse in this cancer. To date, several trials that explored the role of radiation therapy, cytokines, chemoimmunotherapy, vaccines, and Thalidomide have failed to improve the outcome of these patients. Only one trial yielded positive results, but it has been highly criticized from a methodological viewpoint, so that, presently, no adjuvant therapy is recommended in kidney cancer. Risk assessment is key to select individuals for future clinical trials and to adequately compare the populations enrolled in previous studies. Recent advances in the mechanistic comprehension of this disease lead to the development of molecularly targeted agents that changed the natural history of metastatic disease; presently, some of these agents (ie, the multikinase inhibitors Sorafenib, Sunitinib, and Pazopanib, as well as the mTOR Everolimus) are under active evaluation as adjuvant treatments. In this review, we are going to critically address patients' selection issues, the results obtained so far within randomized, controlled, phase III trials, and to present the next generation of adjuvant trials with molecularly targeted agents.
|Journal||European journal of Clinical and Medical Oncology|
|Publication status||Published - 2012|
- Adjuvant therapy
- Clinical trials
- Kidney cancer
ASJC Scopus subject areas