Targeted therapies for non-clear renal cell carcinoma.
The treatment of advanced and metastatic kidney cancer has been revolutionized by the development of targeted systemic therapies. Despite the growing number of available agents approved for use against clear cell renal cell carcinoma, patients with non-clear histologies, constituting approximately 1 in 4 cases of kidney cancer, have not received the same attention. The majority of clinical trials testing novel targeted therapies have excluded non-clear subtypes, providing limited therapeutic options for patients with these diagnoses and their oncologists. This review will focus on the use of targeted therapies against the non-clear histologic subtypes of renal cell carcinoma: papillary I and II, chromophobe, and collecting duct. The unique genetic and molecular profiles of each distinct non-clear kidney cancer subtype will be described, as these differences are integral to the development and effectiveness of the novel agents used to treat them. Trials focusing on non-clear kidney cancer, or those that treated clear cell tumors along with significant numbers of non-clear subtypes, will be discussed. The role of cytoreductive nephrectomy and the use of neoadjuvant and adjuvant targeted therapy will be reviewed. Lastly, areas of future research will be highlighted.
Singer
Eric A
EA
Department of Health and Human Services, Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive Bldg 10 Rm 1-5940, Bethesda, MD 20892, USA. singerea@mail.nih.gov
Bratslavsky
Gennady
G
Linehan
W Marston
WM
Srinivasan
Ramaprasad
R
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002291:Carcinoma, Papillary / Q000235:genetics / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D002292:Carcinoma, Renal Cell / Q000235:genetics / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D015195:Drug Design; D020869:Gene Expression Profiling; D006801:Humans; D007680:Kidney Neoplasms / Q000235:genetics / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D009392:Nephrectomy
D000970:Antineoplastic Agents