Skip to main content
Article thumbnail
Location of Repository

Neoadjuvant targeted therapy in patients with renal cell carcinoma

By B. Ya. Alekseev, K. M. Nyushko and A. S. Kalpinsky


<p>Cytoreductive nephrectomy as an independent option in patients with metastatic renal cell carcinoma (mRCC) cannot be considered as the only effective method, with rare exception, of a few patients with solitary metastases. Cytoreductive nephrectomy is now part of a multimodal approach encompassing surgical treatment and systemic drug therapy. Many retrospective and two prospective studies have demonstrated that it is expedient to perform cytoreductive nephrectomy. Immunotherapy should not be used as preoperatively in the era of cytokine therapy for mRCC due to that fact that it has no impact on primary tumor. In the current targeted therapy era, many investigators have concentrated attention<br />on the role of neoadjuvant targeted therapy for the treatment of patients with both localized and locally advanced mRCC. The potential benefits of neoadjuvant therapy for localized and locally advanced RCC include to make surgery easier and to increase the possibility of organsparing treatment, by decreasing the stage of primary tumor and the size of tumors. The possible potential advantages of neoadjuvant targeted therapy in patients with mRCC include prompt initiation of necessary systemic therapy; identification of patients with primary refractory tumors; and a preoperative reduction in the stage of primary tumor. Numerous retrospective and some prospective phase II studies have shown that neoadjuvant targeted therapy in patients with localized and locally advanced RCC is possible and tolerable and surgical treatment after neoadjuvant targeted therapy is safe and executable with a low incidence of complications. If neoadjuvant therapy is to be performed, it should be done within 2–4 months before surgery. Sorafenib and sunitinib are now most tested and suitable for neoadjuvant targeted therapy. Sorafenib is a more preferred drug due to its shorter half-life and accordingly to the possibility of discontinuing the drug immediately prior to surgery. Unquestionably, elaboration of precise recommendations for neoadjuvant therapy calls for further larger prospective studies estimating progression and survival rates in high-risk patients with localized and locally advanced RCC and in those with mRCC.</p

Topics: renal cell carcinoma, metastatic renal cell carcinoma, cytoreductive nephrectomy, radical nephrectomy, targeted therapy, sorafenib, sunitinib, bevacizumab, axitinib, pazopanib, neoadjuvant targeted therapy, Medicine, R
Publisher: ABV-press
Year: 2015
OAI identifier:
Download PDF:
Sorry, we are unable to provide the full text but you may find it at the following location(s):
  • (external link)
  • (external link)
  • (external link)
  • (external link)
  • Suggested articles

    To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.