SEOM clinical guideline for treatment of kidney cancer (2019)
Por:
Lazaro M, Valderrama B, Suarez C, De-Velasco G, Beato C, Chirivella I, Gonzalez-Del-Alba A, Lainez N, Mendez-Vidal M, Arranz J
Publicada:
1 feb 2020
Ahead of Print:
28 ene 2020
Resumen:
In this article, we review de state of the art on the management of renal cell carcinoma (RCC) and provide recommendations on diagnosis and treatment. Recent advances in molecular biology have allowed the subclassification of renal tumours into different histologic variants and may help to identify future prognostic and predictive factors. For patients with localized disease, surgery is the treatment of choice with nephron-sparing surgery recommended when feasible. No adjuvant therapy has demonstrated a clear benefit in overall survival. Considering the whole population of patients with advanced disease, the combination of axitinib with either pembrolizumab or avelumab increase response rate and progression-free survival, compared to sunitinib, but a longer overall survival has only been demonstrated so far with the pembrolizumab combo. For patients with IMDC intermediate and poor prognosis, nephrectomy should not be considered mandatory. In this subpopulation, the combination of ipilimumab and nivolumab has also demonstrated a superior response rate and overall survival vs. sunitinib. In patients progressing to one or two antiangiogenic tyrosine-kinase inhibitors, both nivolumab and cabozantinib in monotherapy have shown benefit in overall survival compared to everolimus. Although no clear sequence can be recommended, medical oncologists and patients should be aware of the recent advances and new strategies that improve survival and quality of life in patients with metastatic RCC.
Filiaciones:
Lazaro M:
Complexo Hospitalario Universitario Vigo, Med Oncol Dept, EStr Clara Campoamor 341, E-36213 Vigo, Pontevedra, Spain
Valderrama B:
Hosp Universitario Virgen Rocio, Med Oncol Dept, Seville, Spain
Suarez C:
Vall d'Hebron Univ Hosp, Universitat Autonoma Barcelona, Inst Oncol, Med Oncol Dept, Barcelona, Spain
De-Velasco G:
Hosp Universitario, Med Oncol Dept, 12 Octubre, Madrid, Spain
Beato C:
Hosp Universitario Virgen Macarena, Med Oncol Dept, Seville, Spain
Chirivella I:
Univers Valencia, Hosp Clin, Med Oncol Dept, Valencia, Spain
Gonzalez-Del-Alba A:
Hosp Universitario Puerta Hierro, Med Oncol Dept, Madrid, Spain
Lainez N:
Med Oncol Dept, Complejo Hospitalario Navarra, Pamplona, Spain
Mendez-Vidal M:
Univ Cordoba, Reina Sofia Hosp,Maimonides Inst BioMed Res, Med Oncol Dept,Imib, Cordoba, Cordoba, Spain
Arranz J:
Hosp Gen Universitario Gregorio Maranon, Med Oncol Dept, Madrid, Spain
hybrid
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