High Unmet Medical Needs in the Treatment of Renal Cell Carcinoma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 5251

Special Issue Editors

Unit of the Medical Oncology, Department of the Georges Pompidou European Hospital, Assistance-publique Hôpitaux de Paris, Paris-Center, University of Paris, Paris, France
Interests: renal cell carcinoma; cancer immunotherapy
Oncology Department, Antoine Lacassagne Cancer Center, Nice, France
Interests: kidney cancer; renal cell carcinoma; non-clear cell renal cell carcinoma; unmet medical need; predictive biomarker; immune checkpoint inhibitor; VEGFR-TKI; adjuvant; metatastatic
Medical Oncology Department, Institut de Cancérologie Strasbourg Europe, 67200 Strasbourg, France
Interests: renal cell carcinoma; immunotherapy; metastatic renal cell carcinoma; urothelial carcinoma, immune-based combination therapies; drug development in GU
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Special Issue Information

Dear Colleagues,

In the last 15 years, dramatic improvements have been made to the therapeutic landscape of metastatic clear renal cell carcinoma (mccRCC) thanks to anti-angiogenic molecules targeting VEGFR (VEGFR-TKI) and, more recently, immune checkpoint inhibitors (ICI). ICI-based combinations (nivolumab–ipilimumab and pembrolizumab–axitinib) have increased survival in first-line treatment of mccRCC compared to VEGFR-TKI and have consequently been approved in this setting. High rates of complete responses and long-term survival results from these pivotal trials give us a glimpse of a cure for some of our patients in the metastatic setting. New data from anti-PD-1 in the adjuvant setting are even more promising for achieving a cure.

Nevertheless, on a daily basis, we see that a substantial proportion of patients will not respond to the current systemic treatments and the majority will finally progress and die from their disease.

In addition, the major improvements described above have been made in conventional clear cell renal cell carcinoma but not in non-clear cell variants (i.e., papillary, chromophobe, MiTF translocation), where there is no standard systemic treatment.

Thus, many questions are still unanswered on not only how to improve survival but also quality of life in patients with advanced and/or metastatic renal cell carcinoma.

This Special Issue is dedicated to addressing some of these unresolved questions in the management of advanced or metastatic renal cell carcinoma. The scope is deliberately broad to allow contributions on diverse topics such as predictive biomarkers, cytoreductive nephrectomy in the ICI era, systemic therapy sequences, systemic treatment of non-clear cell variants, etc.

Original studies and comprehensive reviews are welcome as well as opinion papers from key opinion leaders, provided that they address a relevant and current issue in the management of patients with advanced renal carcinoma.

We look forward to receiving your contributions.

Sincerely,

Dr. Yann Vano
Dr. Delphine Borchiellini
Dr. Philippe Barthélémy
Guest Editors

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Keywords

  • kidney cancer
  • renal cell carcinoma
  • non-clear cell renal cell carcinoma
  • unmet medical need
  • predictive biomarker
  • immune checkpoint inhibitor
  • VEGFR-TKI
  • adjuvant
  • metastatic

Published Papers (2 papers)

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Review

16 pages, 507 KiB  
Review
Therapeutic Drug Monitoring of Tyrosine Kinase Inhibitors in the Treatment of Advanced Renal Cancer
by Florent Puisset, Mourad Mseddi, Loïc Mourey, Damien Pouessel, Benoit Blanchet, Etienne Chatelut and Christine Chevreau
Cancers 2023, 15(1), 313; https://doi.org/10.3390/cancers15010313 - 03 Jan 2023
Cited by 3 | Viewed by 2192
Abstract
Seven tyrosine kinase inhibitor compounds with anti-angiogenic properties remain key drugs to treat advanced renal cell carcinoma. There is a strong rationale to develop therapeutic drug monitoring for these drugs. General considerations of such monitoring of the several groups of anticancer drugs are [...] Read more.
Seven tyrosine kinase inhibitor compounds with anti-angiogenic properties remain key drugs to treat advanced renal cell carcinoma. There is a strong rationale to develop therapeutic drug monitoring for these drugs. General considerations of such monitoring of the several groups of anticancer drugs are given, with a focus on oral therapy. Pharmacokinetics and the factors of inter- and intraindividual variabilities of these tyrosine kinase inhibitors are described together with an exhaustive presentation of their pharmacokinetic/pharmacodynamic relationships. The latter was observed in studies where every patient was treated with the same dose, and the results of several prospective studies based on dose individualization support the practice of increasing individual dosage in case of low observed plasma drug concentrations. Finally, the benefits and limits of therapeutic drug monitoring as a routine practice are discussed. Full article
(This article belongs to the Special Issue High Unmet Medical Needs in the Treatment of Renal Cell Carcinoma)
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22 pages, 1793 KiB  
Review
Renal Carcinoma and Angiogenesis: Therapeutic Target and Biomarkers of Response in Current Therapies
by Zoé Guillaume, Marie Auvray, Yann Vano, Stéphane Oudard, Dominique Helley and Laetitia Mauge
Cancers 2022, 14(24), 6167; https://doi.org/10.3390/cancers14246167 - 14 Dec 2022
Cited by 8 | Viewed by 2039
Abstract
Due to the aberrant hypervascularization and the high immune infiltration of renal tumours, current therapeutic regimens of renal cell carcinoma (RCC) target angiogenic or immunosuppressive pathways or both. Tumour angiogenesis plays an essential role in tumour growth and immunosuppression. Indeed, the aberrant vasculature [...] Read more.
Due to the aberrant hypervascularization and the high immune infiltration of renal tumours, current therapeutic regimens of renal cell carcinoma (RCC) target angiogenic or immunosuppressive pathways or both. Tumour angiogenesis plays an essential role in tumour growth and immunosuppression. Indeed, the aberrant vasculature promotes hypoxia and can also exert immunosuppressive functions. In addition, pro-angiogenic factors, including VEGF-A, have an immunosuppressive action on immune cells. Despite the progress of treatments in RCC, there are still non responders or acquired resistance. Currently, no biomarkers are used in clinical practice to guide the choice between the different available treatments. Considering the role of angiogenesis in RCC, angiogenesis-related markers are interesting candidates. They have been studied in the response to antiangiogenic drugs (AA) and show interest in predicting the response. They have been less studied in immunotherapy alone or combined with AA. In this review, we will discuss the role of angiogenesis in tumour growth and immune escape and the place of angiogenesis-targeted biomarkers to predict response to current therapies in RCC. Full article
(This article belongs to the Special Issue High Unmet Medical Needs in the Treatment of Renal Cell Carcinoma)
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