Management of oligometastatic and oligoprogressive renal cell carcinoma: state of the art and future directions.

Abstract:

INTRODUCTION:The aim of this paper was to perform a narrative review of the literature on the available approaches in the treatment of two emerging subpopulations of metastatic renal cell carcinoma (mRCC) patients: the oligometastatic disease (less than 5 metastasis) and the oligoprogressive disease, defined as worsening in maximum 3-5 sites while all other tumor sites are controlled by systemic therapy. AREAS COVERED:We explore all possible approaches in these settings of patients: the role of local therapies, considering both surgical metastasectomy and/or ablative techniques, the efficacy of systemic therapies and the rationale behind active surveillance. We also discuss ongoing clinical trials in these settings. EXPERT OPINION:Two different strategies are emerging as the most promising for the approach to the oligometastatic/oligoprogressive mRCC patient: (1) the use of immunocheckpoint inhibitors following metastasectomy; (2) the use of stereotactic radiotherapy alone or combined with immunotherapy for oligometastatic disease. The lack of validated biomarkers of response in these mRCC patient subpopulations is opening the way to the employment of novel technologies. Among them, the use of artificial intelligence seems to be the candidate to contribute to precision oncology in patients with mRCC.

authors

Donini M,Buti S,Massari F,Mollica V,Rizzo A,Montironi R,Bersanelli M,Santoni M

doi

10.1080/14737140.2020.1770601

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

491-501

issue

6

eissn

1473-7140

issn

1744-8328

journal_volume

20

pub_type

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