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Improving outcomes in high-risk, nonmetastatic renal cancer: new data and ongoing trials

Abstract

High-risk, localized renal cancer is associated with recurrence rates of up to 75% at 10 years. The outcomes of patients at this disease stage depend on optimal patient stratification, surgical management and systemic therapy selection. Current evidence does not support the use of adjuvant therapy in patients with high-risk, localized disease. During the past 12 months, the results of large, randomized-controlled trials of adjuvant tyrosine kinase inhibitor (TKI) treatment, such as ASSURE and S-TRAC, have been published, but their findings are conflicting. Whether TKIs will become standard of care in the adjuvant setting depends on the long-term data from ongoing trials. In addition, several new trials that evaluate the utility of novel immune checkpoint inhibitors in this patient group are currently recruiting. The management of renal cancer is likely to evolve at a rapid pace over the next few years and matching patients with the appropriate therapeutic regimen is likely to be a focus of future research.

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Figure 1: Trials of adjuvant targeted treatments in renal cancer.

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C.B. researched data for the article. C.B. and G.S. wrote the manuscript. C.B., G.S., and T.E. made substantial contributions to discussion of the article's content. All authors reviewed and/or edited the manuscript before submission.

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Correspondence to Chris Blick.

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T.E. is a paid employee of Astra Zeneca. G.D.S. has received educational grants, speaker's fees, and travel grants from Pfizer.

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Blick, C., Ritchie, A., Eisen, T. et al. Improving outcomes in high-risk, nonmetastatic renal cancer: new data and ongoing trials. Nat Rev Urol 14, 753–759 (2017). https://doi.org/10.1038/nrurol.2017.123

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