Patient selection and risk factors in the changing treatment landscape of metastatic renal cell carcinoma
| Autor: | Mohamed Abouagour, Ehab Abdou, Enrique Grande, Emad Dawoud, Abdul R Zar, Humaid O. Al-Shamsi, Dalia El-Shourbagy, Ravi M Pedapenki |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.drug_class Immune checkpoint inhibitors medicine.medical_treatment urologic and male genital diseases Malignancy Tyrosine-kinase inhibitor Targeted therapy 03 medical and health sciences 0302 clinical medicine Risk Factors Renal cell carcinoma Antineoplastic Combined Chemotherapy Protocols medicine Humans Pharmacology (medical) Neoplasm Metastasis skin and connective tissue diseases Carcinoma Renal Cell Selection (genetic algorithm) business.industry Patient Selection Prognosis medicine.disease Kidney Neoplasms 030104 developmental biology Oncology 030220 oncology & carcinogenesis Cancer research sense organs business |
| Zdroj: | Expert Review of Anticancer Therapy. 20:831-840 |
| ISSN: | 1744-8328 1473-7140 |
| DOI: | 10.1080/14737140.2020.1810572 |
| Popis: | The approval of combination treatments for metastatic renal cell carcinoma (mRCC) represents a major change in the clinical management of this malignancy. Updated treatment guidelines differentiate first-line mRCC treatment by patient risk group as defined by prognostic models and the number of risk factors.Current prognostic models, with a focus on the International Metastatic RCC Database Consortium and the Memorial Sloan Kettering Cancer Center models, the heterogeneity of the intermediate risk group, and first- and second-line mRCC treatment outcomes according to patient risk group are discussed. Consideration is given to the future direction of treatment selection strategies including refinement of prognostic factors, genetic biomarkers and gene signatures.Current prognostic models require updating, but initial data suggests they are effective in stratifying patients treated with immune checkpoint inhibitors or combination therapy. Treatment selection for patients with 1-2 risk factors may require further consideration due to the heterogeneous nature of the intermediate risk group. Future prognostic models may benefit from inclusion of gene signatures and stratification by molecular subtype. Prognostic risk factors are not the only consideration in treatment selection; tumor burden, location of metastases, and comorbidities, among other factors, should also be considered. |
| Databáze: | OpenAIRE |
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