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Clinical and Translational Oncology
Published in: Clinical and Translational Oncology 2/2020

Open Access 01-02-2020 | Nephrectomy | Clinical Guides in Oncology

SEOM clinical guideline for treatment of kidney cancer (2019)

Authors: M. Lázaro, B. P. Valderrama, C. Suárez, G. de-Velasco, C. Beato, I. Chirivella, A. González-del-Alba, N. Laínez, M. J. Méndez-Vidal, J. A. Arranz

Published in: Clinical and Translational Oncology | Issue 2/2020

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Abstract

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.
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Metadata
Title
SEOM clinical guideline for treatment of kidney cancer (2019)
Authors
M. Lázaro
B. P. Valderrama
C. Suárez
G. de-Velasco
C. Beato
I. Chirivella
A. González-del-Alba
N. Laínez
M. J. Méndez-Vidal
J. A. Arranz
Publication date
01-02-2020
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 2/2020
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-019-02285-7

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