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Current Treatment Considerations in Metastatic Renal Cell Carcinoma

  • Genitourinary Cancer (MJ Morris, Section Editor)
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Opinion statement

In general, debulking neprhectomy is still considered for metastatic RCC patients with primary tumor in place, assuming good performance status. Initial systemic therapy should consider high-dose IL-2 for the highly select patient. One reason for initial consideration of this therapy is the less certain risk/benefit profile if employed after targeted therapy. Notably, due to its potential toxicity and emergence of new effective and more tolerable drugs, IL-2 has become a less favorable and subsequently a less utilized therapeutic tool in the current era. Otherwise, VEGF-targeted therapy is the treatment of choice, preferably on a clinical trial. Off trial, sunitinib has long been favored but pazopanib is gaining more use for tolerance pending the comparative trial. Continued VEGF targeting is favored by these authors given the underlying biology of RCC and the prospective clinical data, noting no direct comparison of mTOR and VEGF agents has yet occurred. Maintaining patient dose is critical and requires optimal supportive care and appreciation/early intervention for toxicity. Predictive biomarkers are desperately needed, and enrollment on clinical trials remains a priority to optimize patient outcome.

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References and Recommended Reading

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  1. Surveillance Epidemiology and End Results. SEER Stat Fact Sheets. National Cancer Institute. Available at http://seer.cancer.gov/statfacts/html/kidrp.html

  2. Rini BI, Campbell SC, Escudier B. Renal cell carcinoma. Lancet. 2009 Mar 28;373(9669):1119–32.

    Article  PubMed  CAS  Google Scholar 

  3. Escudier B, Eisen T, Stadler WM, TARGET Study Group, et al. Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med. 2007;356(2):125–34.

    Article  PubMed  CAS  Google Scholar 

  4. Motzer RJ, Bacik J, Mazumdar M. Prognostic factors for survival of patients with stage IV renal cell carcinoma: memorial sloan-kettering cancer center experience. Clin Cancer Res. 2004;10(18 Pt 2):6302S–3S.

    Article  PubMed  CAS  Google Scholar 

  5. Escudier B, Eisen T, Stadler WM, et al. Sorafenib for treatment of renal cell carcinoma: final efficacy and safety results of the phase III treatment approaches in renal cancer global evaluation trial. J Clin Oncol. 2009 Jul 10;27(20):3312–8.

    Article  PubMed  CAS  Google Scholar 

  6. Escudier B, Szczylik C,. Hutson TE, et al. Randomized phase II trial of first-line treatment with sorafenib versus interferon Alfa-2a in patients with metastatic renal cell carcinoma. J Clin Oncol. 2009 Mar 10; 27(8):1280-9. Epub 2009 Jan 26.

    Google Scholar 

  7. Amato RJ, Harris P, Dalton M, et al. A phase II trial of intra-patient dose-escalated sorafenib in patients (pts) with metastatic renal cell cancer (MRCC). Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No. 18S (June 20 Supplement), 2007:5026.

  8. Gore ME, Jones RJ, Ravaud A, et al. Efficacy and safety of intrapatient dose escalation of sorafenib as first-line treatment for metastatic renal cell carcinoma (mRCC). J Clin Oncol. 2011;29 (suppl; abstr 4609).

    Google Scholar 

  9. Motzer RJ, Agarwal N, Beard C, et al. NCCN clinical practice guidelines in oncology: kidney cancer. Version 2, 2011. Available at: http://www.nccn.org/professionals/physician_gls/pdf/kidney.pdf

  10. Mendel DB, Laird AD, Xin X, et al. In vivo antitumor activity of SU11248, a novel tyrosine kinase inhibitor targeting vascular endothelial growth factor and platelet-derived growth factor receptors: determination of a pharmacokinetic/pharmacodynamic relationship. Clin Cancer Res. 2003;9:327–37.

    PubMed  CAS  Google Scholar 

  11. Motzer RJ, Hutson TE, Tomczak P, et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med. 2007;356(2):115–24.

    Article  PubMed  CAS  Google Scholar 

  12. Raymond E, Faivre S, Vera K, et al. Final results of a phase I and pharmacokinetic study of SU11248, a novel multi-target tyrosine kinase inhibitor in patients with advanced cancers. Proc Am Soc Clin Oncol. 2003;22:192. abstract 769.

    Google Scholar 

  13. Motzer RJ, Michaelson MD, Redman BG, et al. Activity of SU11248, a multitargeted inhibitor of vascular endothelial growth factor receptor and platelet-derived growth factor receptor, in patients with metastatic renal cell carcinoma. J Clin Oncol. 2006;24(1):16–24. Epub 2005 Dec 5.

    Article  PubMed  CAS  Google Scholar 

  14. Motzer RJ, Hutson TE, Tomczak P, et al. Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol. 2009 Aug 1;27(22):3584–90.

    Article  PubMed  CAS  Google Scholar 

  15. Gore ME, Szczylik C, Porta C, et al. Safety and efficacy of sunitinib for metastatic renal-cell carcinoma: an expanded-access trial. Lancet Oncol. 2009 Aug;10(8):757–63.

    Article  PubMed  CAS  Google Scholar 

  16. Motzer RJ, Hutson TE, Olsen MR, et al. Randomized phase II multicenter study of the efficacy and safety of sunitinib on the 4/2 versus continuous dosing schedule as first-line therapy of metastatic renal cell carcinoma: Renal EFFECT Trial. J Clin Oncol. 2011;29 (suppl 7; abstr LBA308).

  17. Garcia-Donas J, Esteban E, Leandro-García LJ, et al. Single nucleotide polymorphism associations with response and toxic effects in patients with advanced renal-cell carcinoma treated with first-line sunitinib: a multicentre, observational, prospective study. Lancet Oncol. 2011 Nov;12(12):1143–50.

    Article  PubMed  CAS  Google Scholar 

  18. Van Erp NP, Eechoute K, van der Veldt AA, et al. Pharmacogenetic pathway analysis for determination of sunitinib-induced toxicity. J Clin Oncol. 2009 Sep 10;27(26):4406–12.

    Article  PubMed  Google Scholar 

  19. Rini BI, Cohen DP, Lu DR, et al. Hypertension as a biomarker of efficacy in patients with metastatic renal cell carcinoma treated with sunitinib. J Natl Canc Inst. 2011;103(9):763–73. Epub 2011 Apr 28.

    Article  CAS  Google Scholar 

  20. Sternberg CN, Davis ID, Mardiak J, et al. Pazopanib in locally advanced or metastatic renal cell carcinoma: results of a randomized phase III trial. J Clin Oncol. 2010 Feb 20;28(6):1061–8.

    Article  PubMed  CAS  Google Scholar 

  21. Sternberg C, Hawkins RE, Szczylik C, et al. Randomized, double-blind phase III study of pazopanib in patients with advanced/metastatic renal cell carcinoma: Final overall survival results (abstract # LBA22). Ann Oncol 2010; 21:viii10.

    Google Scholar 

  22. NCT01217931: sequential two-agent assessment in renal cell carcinoma therapy.

  23. NCT00731211: pazopanib in previously treated patients with metastatic renal cell carcinoma.

  24. NCT00720941:Pazopanib Versus Sunitinib in the Treatment of Locally Advanced and/or Metastatic Renal Cell Carcinoma (COMPARZ)

  25. Escudier B, Pluzanska A, Koralewski P, AVOREN Trial Investigators, et al. Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma: a randomised, double-blind phase III trial. Lancet. 2007;370(9605):2103–11.

    Article  PubMed  Google Scholar 

  26. Escudier B, Bellmunt J, Négrier S, et al. Phase III trial of bevacizumab plus interferon alfa-2a in patients with metastatic renal cell carcinoma (AVOREN): final analysis of overall survival. J Clin Oncol. 2010 May 1;28(13):2144–50.

    Article  PubMed  CAS  Google Scholar 

  27. Rini BI, Halabi S, Rosenberg JE, et al. Bevacizumab plus interferon alfa compared with interferon alfa monotherapy in patients with metastatic renal cell carcinoma: CALGB 90206. J Clin Oncol. 2008;26(33):5422–8.

    Article  PubMed  CAS  Google Scholar 

  28. Rini BI, Halabi S, Rosenberg JE, et al. Phase III trial of bevacizumab plus interferon alfa versus interferon alfa monotherapy in patients with metastatic renal cell carcinoma: final results of CALGB 90206. J Clin Oncol. 2010 May 1;28(13):2137–43.

    Article  PubMed  CAS  Google Scholar 

  29. Bukowski RM, Kabbinavar FF, Figlin RA, et al. Randomized phase II study of erlotinib combined with bevacizumab compared with bevacizumab alone in metastatic renal cell cancer. J Clin Oncol. 2007;25:4536–41.

    Article  PubMed  CAS  Google Scholar 

  30. Yang JC, Haworth L, Sherry RM, et al. A randomized trial of bevacizumab, an anti-vascular endothelial growth factor antibody, for metastatic renal cancer. N Engl J Med. 2003;349:427–34.

    Article  PubMed  CAS  Google Scholar 

  31. Atkins MB, Hidalgo M, Stadler WM, et al. Randomized phase II study of multiple dose levels of CCI-779, a novel mammalian target of rapamycin kinase inhibitor, in patients with advanced refractory renal cell carcinoma. J Clin Oncol. 2004;22(5):909–18.

    Article  PubMed  CAS  Google Scholar 

  32. Hudes G, Carducci M, Tomczak P, for the Global ARCC Trial, et al. Temsirolimus, interferon Alfa, or both for advanced renal-cell carcinoma. N Engl J Med. 2007;356:2271–81.

    Article  PubMed  CAS  Google Scholar 

  33. Maroto JP, Hudes G, Dutcher JP. Drug-related pneumonitis in patients with advanced renal cell carcinoma treated with temsirolimus. J Clin Oncol. 2011;29(13):1750–6.

    Article  PubMed  CAS  Google Scholar 

  34. Dutcher JP, De Souza P, Figlin R, et al. Effect of temsirolimus versus interferon-α on survival of patients with advanced renal cell carcinoma of different tumor histologies. ASCO 2008 Genitourinary cancers symposium. Abstract number 384.

  35. Motzer RJ, Escudier B, Oudard S, et al. Efficacy of everolimus in advanced renal cell carcinoma: a double-blind, randomised, placebo-controlled phase III trial. Lancet. 2008;372:449–56.

    Article  PubMed  CAS  Google Scholar 

  36. Motzer RJ, Escudier B, Oudard S, et al. Phase 3 trial of everolimus for metastatic renal cell carcinoma: final results and analysis of prognostic factors. Cancer. 2010 Sep 15;116(18):4256–65.

    Article  PubMed  CAS  Google Scholar 

  37. Amato RJ, Jac J, Giessinger S, et al. A phase 2 study with a daily regimen of the oral mTOR inhibitor RAD001 (everolimus) in patients with metastatic clear cell renal cell cancer. Cancer. 2009;115:2438–46.

    Article  PubMed  CAS  Google Scholar 

  38. Rini BI, Michaelson MD, Rosenberg JE, et al. Antitumor activity and biomarker analysis of sunitinib in patients with bevacizumab-refractory metastatic renal cell carcinoma. J Clin Oncol. 2008;26:3743–8.

    Article  PubMed  CAS  Google Scholar 

  39. Sablin MP, Bouaita L, Balleyguier C, et al. Sequential use of sorafenib and sunitinib in renal cancer: retrospective analysis in 90 patients [abstract]. J Clin Oncol. 2007;25(18 suppl): Pages. Abstract 5038.

    Google Scholar 

  40. Buchler T, Klapka R, Melichar B, et al. Sunitinib followed by sorafenib or vice versa for metastatic renal cell carcinoma—data from the Czech registry. Ann Oncol (2011) first published online May 2, 2011 doi:10.1093/annonc/mdr065

  41. Weikert S, Kempkensteffen C, Gruenwald V, et al. Sequential use of temsirolimus (TEM) in patients with metastatic renal cell carcinoma (mRCC): safety and efficacy following failure of receptor tyrosine kinase inhibitor (TKI) treatment. ASCO 2010 Genitourinary Cancers Symposium. Abstract 352.

  42. NCT00903175: efficacy and safety comparison of RAD001 versus sunitinib in the first-line and second-line treatment of patients with metastatic renal cell carcinoma (RECORD-3).

  43. NCT00474786: temsirolimus versus sorafenib as second-line therapy in patients with advanced RCC who have failed first-line sunitinib.

  44. NCT00782275: Avastin and temsirolimus following tyrosine kinase inhibitor failure in patients with advanced renal cell carcinoma.

  45. Patel PH, Senico PL, Curiel RE, Motzer RJ. Phase I study combining treatment with temsirolimus and sunitinib malate in patients with advanced renal cell carcinoma. Clin Genitourin Canc. 2009;7(1):24–7.

    Google Scholar 

  46. Patnaik A, Ricart A, Cooper J, et al. A phase I, pharmacokinetic and pharmacodynamic study of sorafenib (S), a multi-targeted kinase inhibitor in combination with temsirolimus (T), an mTOR inhibitor in patients with advanced solid malignancies. J Clin Oncol (Meeting Abstracts). 2007;25(18_Suppl):3512.

    Google Scholar 

  47. Sosman JA, Flaherty KT, Atkins MB, et al. Updated results of phase I trial of sorafenib (S) and bevacizumab (B) in patients with metastatic renal cell cancer (mRCC) [abstract]. J Clin Oncol. 2008;26(May 20 suppl). Abstract 5011.

    Google Scholar 

  48. Feldman DR, Ginsberg MS, Baum M, et al. Phase I trial of bevacizumab plus sunitinib in patients with metastatic renal cell carcinoma [abstract]. J Clin Oncol. 2008;26(May 20 suppl). Abstract 5100.

    Google Scholar 

  49. Cen P, Daleiden A, Doshi G, et al. A phase I study of everolimus plus sorafenib in patients with metastatic renal cell carcinoma (mRCC) ASCO. Meet Abstr. 2009;27:e16056.

    Google Scholar 

  50. Kroog GS, Feldman DR, Kondagunta GV, et al. Phase I trial of RAD001 (everolimus) plus sunitinib in patients with metastatic renal cell carcinoma. ASCO Meet Abstr. 2009;27:5037.

    Google Scholar 

  51. Escudier BJ, Negrier S, Gravis G, et al. Can the combination of temsirolimus and bevacizumab improve the treatment of metastatic renal cell carcinoma (mRCC)? results of the randomized TORAVA phase II trial. J Clin Oncol. 2010;28:15s (suppl; abstr 4516).

  52. Hainsworth JD, Spigel DR, Burris HA, et al. Phase II trial of bevacizumab and everolimus in patients with advanced renal cell carcinoma. J Clin Oncol. 2010;28:2131–6.

    Google Scholar 

  53. NCT00378703: the BeST trial: a randomized phase II study of VEGF, RAF kinase, and mTOR Combination Targeted Therapy (CTT) with Bevacizumab, Sorafenib and Temsirolimus in advanced renal cell carcinoma [BeST].

  54. NCT00491738: a study evaluating the efficacy and safety of sunitinib with or without Bevacizumab in first-line patients with metastatic renal cell cancer (SABRE-R).

  55. NCT00719264: a randomized, open-label, multi-center phase II study to compare Bevacizumab plus RAD001 versus interferon alfa-2a plus Bevacizumab for the first-line treatment of patients with metastatic clear cell carcinoma of the kidney.

  56. NCT00631371: a study comparing bevacizumab + temsirolimus vs. bevacizumab + Interferon-Alfa in Advanced Renal Cell Carcinoma Subjects (INTORACT).

    Google Scholar 

  57. NCT01198158: everolimus with or without Bevacizumab in treating patients with advanced kidney cancer that progressed after first-line therapy.

    Google Scholar 

  58. Escudier B. How to interpret phase II data for everolimus plus bevacizumab in renal cell carcinoma. J Clin Oncol. 2010;28(13):2125–6. Epub 2010 Apr 5.

    Article  PubMed  Google Scholar 

  59. Rosenberg SA, Lotze MT, Muul LM, et al. Observations on the systemic administration of autologous lymphokine-activated killer cells and recombinant interleukin-2 to patients with metastatic cancer. N Engl J Med. 1985;313:1485–92.

    Article  PubMed  CAS  Google Scholar 

  60. Fyfe G, Fisher RI, Rosenberg SA, Sznol M, Parkinson DR, Louie AC. Results of treatment of 255 patients with metastatic renal cell carcinoma who received high-dose recombinant interleukin-2 therapy. J Clin Oncol. 1995;13(3):688–96.

    PubMed  CAS  Google Scholar 

  61. Fisher RI, Rosenberg SA, Fyfe G. Long-term survival update for high-dose recombinant interleukin-2 in patients with renal cell carcinoma. Canc J Sci Am. 2000;6 Suppl 1:S55–7.

    Google Scholar 

  62. Schwarzberg T, Regan MM, Liu V, et al. Retrospective analysis of interleukin-2 therapy in patients with metastatic renal cell carcinoma who had received prior antiangiogenic therapy [abstract]. J Clin Oncol. 2008;26(suppl). Abstract 5044.

    Google Scholar 

  63. Coppin C, Porzsolt F, Awa A, et al. Immunotherapy for advanced renal cell cancer. Cochrane Database Syst Rev. 2005 Jan 25;(1):CD001425.

  64. Motzer RJ, Bacik J, Murphy BA, et al. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol. 2002;20(1):289–96.

    Article  PubMed  CAS  Google Scholar 

  65. Hudes GR, Carducci MA, Choueiri TK, et al. NCCN Task Force Report: optimizing treatment of advanced renal cell carcinoma with molecular targeted therapy. J Natl Compr Canc Netw. 2011;9:S1–S29.

    PubMed  CAS  Google Scholar 

  66. NCT01223027: an open-label, randomized, multi-center, phase III study to compare the safety and efficacy of TKI258 versus sorafenib in patients with metastatic renal cell carcinoma after failure of anti-angiogenic (VEGF-targeted and mTOR Inhibitor) therapies.

  67. IMA901 Multipeptide Vaccine Randomized International Phase III Trial (IMPRINT): a randomized, controlled study investigating IMA901 multipeptide cancer vaccine in patients receiving sunitinib as first-line therapy for advanced/metastatic RCC. J Clin Oncol. 2011;29(suppl; abstr TPS183).

  68. Rini BI, Wilding G, Hudes G, et al. Phase II study of axitinib in sorafenib-refractory metastatic renal cell carcinoma. J Clin Oncol. 2009;27:4462–8.

    Article  PubMed  CAS  Google Scholar 

  69. Rixe O, Bukowski RM, Michaelson MD, et al. Axitinib treatment in patients with cytokine-refractory metastatic renal-cell cancer: a phase II study. Lancet Oncol. 2007;8:975–84.

    Article  PubMed  Google Scholar 

  70. Rini BI, Escudier B, Tomczak P, et al. Comparative effectiveness of axitinib versus sorafenib in advanced renal cell carcinoma (AXIS): a randomised phase 3 trial. Lancet. 2011 Dec 3;378(9807):1931–9. Epub 2011 Nov 4.

    Article  PubMed  CAS  Google Scholar 

  71. NCT00835978: axitinib (AG-013736) with or without dose titration (increase) in patients with kidney cancer.

  72. Nosov D, Bhargava P, Esteves WB, et al. Final analysis of the phase II randomized discontinuation trial (RDT) of tivozanib (AV-951) versus placebo in patients with renal cell carcinoma (RCC). J Clin Oncol 29: 2011 (suppl; abstr 4550)

  73. NCT01030783: a phase 3, randomized, controlled, multi-center, open-label study to compare tivozanib (AV-951) to sorafenib in subjects with advanced renal cell carcinoma (TIVO-1).

  74. Angevin E, Lin C, Pande AU, et al. A phase I/II study of dovitinib (TKI258), a FGFR and VEGFR inhibitor, in patients (pts) with advanced or metastatic renal cell cancer: phase I results [abstract]. J Clin Oncol. 2010;28(Suppl 18S):Abstract 3057.

  75. Angevin E. A phase I/II study of TKI258 (dovitinib), a FGFR and VEGFR inhibitor, in patients (pts) with advanced or metastatic renal cell cancer (mRCC): preliminary phase II results [abstract]. Presented at the 35th European Society for Medical Oncology (ESMO) Congress; October 8–12, 2010; Milan, Italy. Abstract 507P.

  76. NCT01223027: study of TKI258 versus sorafenib in patients with metastatic renal cell carcinoma.

  77. Reinhardt C, Zdrojowy R, Szczylik C, et al. Results of a randomized phase II study investigating multipeptide vaccination with IMA901 in advanced renal cell carcinoma (RCC). J Clin Oncol. 2010;28:15s. suppl; abstr 4529.

    Google Scholar 

  78. Rini BI, Eisen T, Stenzl A, et al. IMA901 multipeptide vaccine randomized international phase III trial (IMPRINT): a randomized, controlled study investigating IMA901 multipeptide cancer vaccine in patients receiving sunitinib as first-line therapy for advanced/metastatic RCC. J Clin Oncol. 2011;29(suppl; abstr TPS183).

  79. Sznol M, Powderly JD, Smith DC, et al. Safety and antitumor activity of biweekly MDX-1106 (Anti-PD-1, BMS-936558/ONO-4538) in patients with advanced refractory malignancies. J Clin Oncol. 2010;28:15s. suppl; abstr 2506.

    Google Scholar 

  80. NCT01354431: a randomized, blinded, phase 2 dose-ranging study Of BMS-936558 (MDX-1106) in subjects with progressive, advanced/metastatic clear-cell renal cell carcinoma who have received prior anti-angiogenic therapy.

  81. Appleman LJ, Gordan MS, Samlowski W, et al. Open-label phase 1b study of AMG 386, a selective angiopoietin1/2-neutralizing peptibody, in combination with sorafenib or sunitinib in advanced renal cell carcinoma (RCC): interim results [abstract]. Presented at the 35th European Society for Medical Oncology (ESMO) Congress; October 8–12, 2010; Milan, Italy. Abstract 505P.

  82. Rini BI, Szczylik C, Tannir NM, et al. AMG 386 in combination with sorafenib in patients (pts) with metastatic renal cell cancer (mRCC): a randomized, double-blind, placebo-controlled, phase II study. J Clin Oncol. 2011;29 (suppl 7; abstr 309).

  83. NCT00853372: phase 2 open-label, multi-center study to evaluate the safety and efficacy of sunitinib malate in combination with AMG 386 as first line or second line therapy for subjects with metastatic renal cell carcinoma.

  84. Knox JJ. Progression-free survival as endpoint in metastatic RCC? Lancet. 2008;372(9637):427–9. Epub 2008 Jul 22.

    Article  PubMed  Google Scholar 

  85. Hotte SJ, Bjarnason GA, Heng DYC, et al. Progression-free survival as a clinical trial endpoint in advanced renal cell carcinoma. Curr Oncol. 2011;18(Supplement 2):S11–9.

    PubMed  Google Scholar 

  86. Delea TE, Khuu A, Kay A, Zheng J, Baladi JF. Association between treatment effects on disease progression (dp) endpoints and overall survival (os) in patients with metastatic renal cell carcinoma (mrcc) [abstract 5105]. J Clin Oncol. 2009:27.

  87. Heng DY, Xie W, Bjarnason GA, et al. Progression-free survival as a predictor of overall survival in metastatic renal cell carcinoma treated with contemporary targeted therapy. Cancer. 2011;117:2637–42. doi:10.1002/cncr.25750.

    Article  PubMed  Google Scholar 

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Disclosure

BI Rini: Consultancy for Pfizer, AVEO, GlaxoSmithKline and Bayer/Onyx, has grants/grants pending with Pfizer and GlaxoSmithKline, and has had travel/accommodations expenses covered or reimbursed by Pfizer, AVEO, and GlaxoSmithKline; H Haddad: none.

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Haddad, H., Rini, B.I. Current Treatment Considerations in Metastatic Renal Cell Carcinoma. Curr. Treat. Options in Oncol. 13, 212–229 (2012). https://doi.org/10.1007/s11864-012-0182-8

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