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Treatment Advancement in Localized and Metastatic Renal Cell Carcinoma

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

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 10005

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Special Issue Editor

Dr. Makito Miyake

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Guest Editor

Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan
Interests: renal cell carcinoma; urothelial carcinoma; prostate cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Basic research and clinical studies have improved our understanding of renal cell carcinoma (RCC), which is one of the most heterogeneous diseases in terms of the biology and clinical behavior. RCC consists of many different subtypes; therefore, there is an urgent need for optimization of precision medicine. In the last couple of decades, advancements in the medical field have helped to create tailored surgical interventions and targeted therapies, such as tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs), to treat localized tumors and advanced, unresectable, and metastatic RCC. However, the current state of precision medicine and the challenges associated with it remain to be faced and overcome.

This Special Issue aims to present a series of original research articles and comprehensive review articles that will highlight the progress that has been made and state of the art in the diagnosis, diverse biology, and treatment of RCC. Topics of interest include advancements in surgical intervention such as robot-assisted surgery, minimally invasive intervention such as cryotherapy, and possible clinical and molecular markers for TKIs and ICIs.

In this Special Issue, original research articles and comprehensive reviews are welcome, as are opinion papers from leaders or experts on relevant and current issues in the management of patients with RCC.

I look forward to receiving your contributions.

Dr. Makito Miyake
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

renal cell carcinoma
tyrosine kinase inhibitors
checkpoint inhibitors
immunotherapy
precision medicine
biomarkers
surgery
cryotherapy
tumor microenvironment
treatment resistance

Published Papers (6 papers)

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Research

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11 pages, 2277 KiB

Open AccessArticle

Impact of Complete Surgical Resection of Metastatic Lesions in Patients with Advanced Renal Cell Carcinoma in the Era of Tyrosine Kinase Inhibitors and Immune Checkpoint Inhibitors

by Takuto Shimizu, Makito Miyake, Nobutaka Nishimura, Takanori Yoshida, Yoshitaka Itami, Akira Tachibana, Chihiro Omori, Yuki Oda, Mikiko Kohashi, Mitsuru Tomizawa, Kenta Onishi, Shunta Hori, Yosuke Morizawa, Daisuke Dotoh, Yasushi Nakai, Kazumasa Torimoto, Nobumichi Tanaka and Kiyohide Fujimoto

Cancers 2024, 16(4), 841; https://doi.org/10.3390/cancers16040841 - 19 Feb 2024

Viewed by 700

Abstract

Complete metastasectomy (CM) in metastatic renal cell carcinoma (mRCC) has demonstrated efficacy in the cytokine era, but its effectiveness in the era of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) remains unclear. A multi-institutional database included clinicopathological data of 367 patients with mRCC. Patients were divided into two groups: the CM group and the non-CM group. These two groups were compared before and after propensity score matching (PSM). Cox proportional hazard models were used to detect factors associated with disease-free survival (DFS) and overall survival (OS) from mRCC diagnosis. The CM group showed a significant association with longer overall survival compared to the non-CM group in the PSM-unadjusted cohorts (p < 0.001, hazard ratio 0.49, 95% confidence interval 0.35–0.69), but no superiority was noted in the adjusted cohorts. The median DFS after CM was 24 months, with no significant differences based on relapse timing. Notably, the international metastatic RCC database consortium risk categories and metastatic burden were associated with DFS. This study supports the potential of CM in mRCC management during the TKI/ICI era, although limitations including sample size and selection bias need to be considered. Full article

(This article belongs to the Special Issue Treatment Advancement in Localized and Metastatic Renal Cell Carcinoma)

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12 pages, 737 KiB

Open AccessArticle

Should We Always Perform Preoperative Chest Computed Tomography in Patients with cT1a Renal Cell Carcinoma?

by Jae-Wook Chung, Jun-Koo Kang, Se Won Jang, Eun Hye Lee, So Young Chun, Seock Hwan Choi, Jun Nyung Lee, Bum Soo Kim, Hyun Tae Kim, See Hyung Kim, Tae-Hwan Kim, Eun Sang Yoo, Tae Gyun Kwon, Dong Jin Park and Yun-Sok Ha

Cancers 2022, 14(22), 5558; https://doi.org/10.3390/cancers14225558 - 12 Nov 2022

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Abstract

No definitive criteria regarding the performance of preoperative chest computed tomography (CT) in patients with cT1a renal cell carcinoma (RCC) exists. We aimed to establish an objective standard for the optimal timing of preoperative chest CT in patients with RCC. Data from 890 patients who underwent surgical treatment for RCC between January 2011 and December 2020 were retrospectively collected. The primary endpoint was detection of lung metastasis on chest CT before nephrectomy. A multivariable logistic regression model predicting positive chest CT scans was used. Predictors included preoperative cTN stage, presence of systemic symptoms, Charlson comorbidity index (CCI), platelet count/hemoglobin ratio, albumin/globulin ratio (AGR), and De Ritis ratio. The overall rate of positive chest CT scans before nephrectomy was 3.03% (27/890). Only one patient had lung metastasis before surgery for cT1a. cT stage (≥cT1b), CCI ≥4, and low AGR were associated with a higher risk of positive chest CT scans. The best cutoff value for AGR was 1.39. After 890-sample bootstrap validation, the concordance index was 0.80. The net benefit of the proposed strategy was superior to that of the select-all and select-none strategies according to decision curve analysis. Therefore, when chest CT scans were performed with a risk of a positive result ≥10%, 532 (59.8%) negative chest CT scans could be prevented. Only 24 (2.7%) potentially positive chest CT scans were misdiagnosed. Therefore, we recommend chest CT in patients with ≥cT1b disease, CCI ≥4, and low AGR. Full article

(This article belongs to the Special Issue Treatment Advancement in Localized and Metastatic Renal Cell Carcinoma)

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Graphical abstract

10 pages, 1244 KiB

Open AccessArticle

Effectiveness and Safety of Molecular-Targeted Therapy after Nivolumab Plus Ipilimumab for Advanced or Metastatic Renal Cell Carcinoma: A Multicenter, Retrospective Cohort Study

by Koji Iinuma, Koji Kameyama, Tomoki Taniguchi, Kei Kawada, Takashi Ishida, Kimiaki Takagi, Shingo Nagai, Torai Enomoto, Masayuki Tomioka, Makoto Kawase, Shinichi Takeuchi, Daiki Kato, Manabu Takai, Keita Nakane and Takuya Koie

Cancers 2022, 14(19), 4579; https://doi.org/10.3390/cancers14194579 - 21 Sep 2022

Cited by 2 | Viewed by 1415

Abstract

This study aimed to evaluate the effectiveness and safety of molecular-targeted therapies (MTTs) after the discontinuation of nivolumab and ipilimumab (NIVO+IPI) combination therapy in patients who had been diagnosed with advanced/metastatic renal cell carcinoma as real-world outcomes. We enrolled patients treated with MTTs following initial therapy with NIVO+IPI at nine institutions in Japan. We evaluated the objective response rate (ORR) as the primary endpoint and disease control rate (DCR), best overall response, and oncological outcomes (overall survival (OS) and progression-free survival (PFS)) as the secondary endpoints. We also evaluated factors predictive of disease progression after the administration of MTTs. Patients were followed up for a median of 8 months. The ORR was 44.8%, and the DCR was 72.4%. The median OS and PFS of MTTs after NIVO+IPI were 18 months and 8 months, respectively. A total of 31% of patients experienced grade 3/4 MTT-related adverse events. The median PFS in patients with bone metastases was significantly shorter than that in those without bone metastases (4 vs. 12 months, p = 0.012). MTTs may be a useful secondary treatment option after the discontinuation of NIVO+IPI. Full article

(This article belongs to the Special Issue Treatment Advancement in Localized and Metastatic Renal Cell Carcinoma)

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10 pages, 937 KiB

Open AccessArticle

On-Clamp vs. Off-Clamp Robot-Assisted Partial Nephrectomy for cT2 Renal Tumors: Retrospective Propensity-Score-Matched Multicenter Outcome Analysis

by Aldo Brassetti, Giovanni E. Cacciamani, Andrea Mari, Juan D. Garisto, Riccardo Bertolo, Chandru P. Sundaram, Ithaar Derweesh, Ahmet Bindayi, Prokar Dasgupta, James Porter, Alexander Mottrie, Luigi Schips, Koon Ho Rah, David Y. T. Chen, Chao Zhang, Kenneth Jacobsohn, Umberto Anceschi, Alfredo M. Bove, Manuela Costantini, Mariaconsiglia Ferriero, Riccardo Mastroianni, Leonardo Misuraca, Gabriele Tuderti, Alexander Kutikov, Wesley M. White, Stephen T. Ryan, Francesco Porpiglia, Jihad Kaouk, Andrea Minervini, Inderbir Gill, Riccardo Autorino and Giuseppe Simone Show full author list Hide full author list

Cancers 2022, 14(18), 4431; https://doi.org/10.3390/cancers14184431 - 13 Sep 2022

Cited by 15 | Viewed by 1704

Abstract

We compared perioperative outcomes after on-clamp versus off-clamp robot-assisted partial nephrectomy (RAPN) for >7 cm renal masses. A multicenter dataset was queried for patients who had undergone RAPN for a cT2cN0cM0 kidney tumor from July 2007 to February 2022. The Trifecta achievement (negative surgical margins, no severe complications, and ≤ 30% postoperative estimated glomerular filtration rate (eGFR) reduction) was considered a surrogate of surgical quality. Overall, 316 cases were included in the analysis, and 58% achieved the Trifecta. A propensity-score-matched analysis generated two cohorts of 89 patients homogeneous for age, ASA score, preoperative eGFR, and RENAL score (all p > 0.21). Compared to the on-clamp approach, OT was significantly shorter in the off-clamp group (80 vs. 190 min; p < 0.001), the incidence of sRFD was lower (22% vs. 40%; p = 0.01), and the Trifecta rate higher (66% vs. 46%; p = 0.01). In a crude analysis, >20 min of hilar clamping was associated with a significantly higher risk of sRFD (OR: 2.30; 95%CI: 1.13–4.64; p = 0.02) and with reduced probabilities of achieving the Trifecta (OR: 0.46; 95%CI: 0.27–0.79; p = 0.004). Purely off-clamp RAPN seems to be a safe and viable option to treat cT2 renal masses and may outperform the on-clamp approach regarding perioperative surgical outcomes. Full article

(This article belongs to the Special Issue Treatment Advancement in Localized and Metastatic Renal Cell Carcinoma)

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Review

Jump to: Research

20 pages, 10254 KiB

Open AccessReview

MR Virtual Biopsy of Solid Renal Masses: An Algorithmic Approach

by Stephane Chartier and Hina Arif-Tiwari

Cancers 2023, 15(10), 2799; https://doi.org/10.3390/cancers15102799 - 17 May 2023

Cited by 1 | Viewed by 1558

Abstract

Between 1983 and 2002, the incidence of solid renal tumors increased from 7.1 to 10.8 cases per 100,000. This is in large part due to the increase in the volume of ultrasound and cross-sectional imaging, although a majority of solid renal tumors are still found incidentally. Ultrasound and computed tomography (CT) have been the mainstay of renal mass screening and diagnosis but recent advances in magnetic resonance (MR) technology have made this the optimal choice when diagnosing and staging renal tumors. Our purpose in writing this review is to survey the modern MR imaging approach to benign and malignant solid renal tumors, consolidate the various imaging findings into an easy-to-read reference, and provide an imaging-based, algorithmic approach to renal mass characterization for clinicians. MR is at the forefront of renal mass characterization, surpassing ultrasound and CT in its ability to describe multiple tissue parameters and predict tumor biology. Cutting-edge MR protocols and the integration of diagnostic algorithms can improve patient outcomes, allowing the imager to narrow the differential and better guide oncologic and surgical management. Full article

(This article belongs to the Special Issue Treatment Advancement in Localized and Metastatic Renal Cell Carcinoma)

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18 pages, 3710 KiB

Open AccessReview

A New Treatment Landscape for RCC: Association of the Human Microbiome with Improved Outcomes in RCC

by Xuan-Mei Piao, Young Joon Byun, Chuang-Ming Zheng, Sun Jin Song, Ho Won Kang, Won Tae Kim and Seok Joong Yun

Cancers 2023, 15(3), 935; https://doi.org/10.3390/cancers15030935 - 01 Feb 2023

Cited by 4 | Viewed by 1918

Abstract

Microbes play different roles in metabolism, local or systemic inflammation, and immunity, and the human microbiome in tumor microenvironment (TME) is important for modulating the response to immunotherapy in cancer patients. Renal cell carcinoma (RCC) is an immunogenic tumor, and immunotherapy is the backbone of its treatment. Correlations between the microbiome and responsiveness to immune checkpoint inhibitors have been reported. This review summarizes the recent therapeutic strategies for RCC and the effects of TME on the systemic therapy of RCC. The current understanding and advances in microbiome research and the relationship between the microbiome and the response to immunotherapy for RCC are also discussed. Improving our understanding of the role of the microbiome in RCC treatment will facilitate the development of microbiome targeting therapies to modify the tumor microbiome and improve treatment outcomes. Full article

(This article belongs to the Special Issue Treatment Advancement in Localized and Metastatic Renal Cell Carcinoma)

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