SEOM SOGUG clinical guideline for treatment of kidney cancer (2022)

• María José Méndez-Vidal ^[6] ; Martin Lázaro Quintela ^[7] ; Nuria Lainez-Milagro ^[1] ; Begoña Perez-Valderrama ^[2] ; Cristina Suárez Rodriguez ^[8] ; José Ángel Arranz Arija ^[3] ; Ignacio Peláez Fernández ^[4] ; Enrique Gallardo Díaz ^[9] ; Julio Lambea Sorrosal ^[5] ; Aránzazu González-del-Alba ^[10]
  1. [1] Hospital Universitario de Navarra

     Hospital Universitario de Navarra

     Pamplona, España

     
  2. [2] Hospital Universitario Virgen del Rocío

     Hospital Universitario Virgen del Rocío

     Sevilla, España

     
  3. [3] Hospital General Universitario Gregorio Marañón

     Hospital General Universitario Gregorio Marañón

     Madrid, España

     
  4. [4] Hospital de Cabueñes

     Hospital de Cabueñes

     Gijón, España

     
  5. [5] Hospital Clínico Universitario Lozano Blesa

     Hospital Clínico Universitario Lozano Blesa

     Zaragoza, España

     
  6. [6] Departamento de Oncología Médica, Instituto Maimónides de Investigaciones Biomédicas de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Córdoba, España
  7. [7] Servicio de Oncología Médica, Hospital Alvaro Cunqueiro-Complejo Hospitalario Universitario de Vigo, Pontevedra, España
  8. [8] Servicio de Oncología Médica, Hospital Universitario Vall D’Hebron, Barcelona, España
  9. [9] Servicio de Oncología Médica, Corporació Sanitària Parc Taulì, Barcelona, España
  10. [10] Servicio de Oncología Médica, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, España

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 25, Nº. 9 (September), 2023, págs. 2732-2748
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Renal cancer is the seventh most common cancer in men and the tenth in women. The aim of this article is to review the diagnosis, treatment, and follow-up of renal carcinoma accompanied by recommendations with new evidence and treatment algorithms. A new pathologic classification of RCC by the World Health Organization (WHO) was published in 2022 and this classification would be considered a “bridge” to a future molecular classification. For patients with localized disease, surgery is the treatment of choice with nephron-sparing surgery recommended when feasible. Adjuvant treatment with pembrolizumab is an option for intermediate-or high-risk cases, as well as patients after complete resection of metastatic disease. More data are needed in the future, including positive overall survival data. Clinical prognostic classification, preferably IMDC, should be used for treatment decision making in mRCC. Cytoreductive nephrectomy should not be deemed mandatory in individuals with intermediate-poor IMDC/MSKCC risk who require systemic therapy. Metastasectomy can be contemplated in selected subjects with a limited number of metastases or long metachronous disease-free interval. For the population of patients with metastatic ccRCC as a whole, the combination of pembrolizumab–axitinib, nivolumab–cabozantinib, or pembrolizumab–lenvatinib can be considered as the first option based on the benefit obtained in OS versus sunitinib. In cases that have an intermediate IMDC and poor prognosis, the combination of ipilimumab and nivolumab has demonstrated superior OS compared to sunitinib. As for individuals with advanced RCC previously treated with one or two antiangiogenic tyrosine-kinase inhibitors, nivolumab and cabozantinib are the options of choice. When there is progression following initial immunotherapy-based treatment, we recommend treatment with an antiangiogenic tyrosine-kinase inhibitor. While no clear sequence can be advocated, medical oncologists and patients should be aware of the recent advances and new strategies that improve survival and quality of life in the setting of metastatic RC.