Skip to main content

Advertisement

SpringerLink
Log in

Overview of Current and Future Adjuvant Therapy for High-Risk Localized Renal Cell Carcinoma

  • Genitourinary Cancers (N Agarwal, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

High-risk localized renal cell carcinoma represents a therapeutic challenge with high recurrence rates and poor survival with nephrectomy alone. Multiple agents targeting angiogenic and immunologic pathways have demonstrated remarkable efficacy in the metastatic setting but have failed to replicate similar successes in localized disease. Study results with adjuvant anti-angiogenic therapies may have been compromised by the high incidence of treatment discontinuations or dosage reductions secondary to intolerable side effects. Improving patient selection could play a major role in improving outcomes. Multiple models exist to predict survival but require improved accuracy in identifying recurrence to justify exposing patients to therapies that could significantly impair quality of life. Further understanding of pathological and molecular mechanisms of recurrence is required. Novel tools like gene recurrence scores are emerging to improve prognostication for patient selection. Immunotherapeutic approaches using check point inhibition have the potential to achieve sustained remissions with a significantly improved toxicity profile. Amplifying the immune response with a combination of neoadjuvant and adjuvant therapy to exploit the larger antigenic burden prior to nephrectomy has the biologic potential for making significant improvements in efficacy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as:•Of importance •• Of major importance

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67(1):7–30. https://doi.org/10.3322/caac.21387.

    Article  PubMed  Google Scholar 

  2. Pal SK, Ghate SR, Li N, Swallow E, Peeples M, Zichlin ML, et al. Real-world survival outcomes and prognostic factors among patients receiving first targeted therapy for advanced renal cell carcinoma: a SEER-Medicare database analysis. Clin Genitourin Cancer. 2017;15(4):e573–e82. https://doi.org/10.1016/j.clgc.2016.12.005.

  3. Kane CJ, Mallin K, Ritchey J, Cooperberg MR, Carroll PR. Renal cell cancer stage migration: analysis of the National Cancer Data Base. Cancer. 2008;113(1):78–83. https://doi.org/10.1002/cncr.23518.

    Article  PubMed  Google Scholar 

  4. Cancer Stat Facts: Kidney and Renal Pelvis Cancer. Surveillance, Epidemiology and End results program (SEER); 2017.

  5. Speed JM, Trinh QD, Choueiri TK, Sun M. Recurrence in localized renal cell carcinoma: a systematic review of contemporary data. Curr Urol Rep. 2017;18(2):15. https://doi.org/10.1007/s11934-017-0661-3.

    Article  PubMed  Google Scholar 

  6. Eggener SE, Yossepowitch O, Pettus JA, Snyder ME, Motzer RJ, Russo P. Renal cell carcinoma recurrence after nephrectomy for localized disease: predicting survival from time of recurrence. J Clin Oncol. 2006;24(19):3101–6. https://doi.org/10.1200/JCO.2005.04.8280.

    Article  PubMed  Google Scholar 

  7. Fuhrman SA, Lasky LC, Limas C. Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol. 1982;6(7):655–63. https://doi.org/10.1097/00000478-198210000-00007.

    Article  CAS  PubMed  Google Scholar 

  8. Novara G, Martignoni G, Artibani W, Ficarra V. Grading systems in renal cell carcinoma. J Urol. 2007;177(2):430–6. https://doi.org/10.1016/j.juro.2006.09.034.

    Article  PubMed  Google Scholar 

  9. Golshayan AR, George S, Heng DY, Elson P, Wood LS, Mekhail TM, et al. Metastatic sarcomatoid renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy. J Clin Oncol. 2009;27(2):235–41. https://doi.org/10.1200/JCO.2008.18.0000.

  10. Sengupta S, Lohse CM, Leibovich BC, Frank I, Thompson RH, Webster WS, et al. Histologic coagulative tumor necrosis as a prognostic indicator of renal cell carcinoma aggressiveness. Cancer. 2005;104(3):511–20. https://doi.org/10.1002/cncr.21206.

  11. Galfano A, Novara G, Iafrate M, Cavalleri S, Martignoni G, Gardiman M, et al. Mathematical models for prognostic prediction in patients with renal cell carcinoma. Urol Int. 2008;80(2):113–123. Reviews conventional prognostic models for prognosis in localized RCC. https://doi.org/10.1159/000112599.

  12. Cindolo L, de la Taille A, Messina G, Romis L, Abbou CC, Altieri V, et al. A preoperative clinical prognostic model for non-metastatic renal cell carcinoma. BJU Int. 2003;92(9):901–5. https://doi.org/10.1111/j.1464-410X.2003.04505.x.

  13. Kattan MW, Reuter V, Motzer RJ, Katz J, Russo P. A postoperative prognostic nomogram for renal cell carcinoma. J Urol. 2001;166(1):63–7. https://doi.org/10.1016/S0022-5347(05)66077-6.

    Article  CAS  PubMed  Google Scholar 

  14. Karakiewicz PI, Briganti A, Chun FK, Trinh QD, Perrotte P, Ficarra V, et al. Multi-institutional validation of a new renal cancer-specific survival nomogram. J Clin Oncol. 2007;25(11):1316–22. https://doi.org/10.1200/JCO.2006.06.1218.

    Article  PubMed  Google Scholar 

  15. Zisman A, Pantuck AJ, Wieder J, Chao DH, Dorey F, Said JW, et al. Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma. J Clin Oncol. 2002;20(23):4559–66. https://doi.org/10.1200/JCO.2002.05.111.

  16. Yap TA, Eisen TG. Adjuvant therapy of renal cell carcinoma. Clin Genitourin Cancer. 2006;5(2):120–30. https://doi.org/10.3816/CGC.2006.n.028.

    Article  CAS  PubMed  Google Scholar 

  17. Patard JJ, Kim HL, Lam JS, Dorey FJ, Pantuck AJ, Zisman A, et al. Use of the University of California Los Angeles integrated staging system to predict survival in renal cell carcinoma: an international multicenter study. J Clin Oncol. 2004;22(16):3316–22. https://doi.org/10.1200/JCO.2004.09.104.

  18. Downs TM, Schultzel M, Shi H, Sanders C, Tahir Z, Sadler GR. Renal cell carcinoma: risk assessment and prognostic factors for newly diagnosed patients. Crit Rev Oncol Hematol. 2009;70(1):59–70. https://doi.org/10.1016/j.critrevonc.2008.08.006.

    Article  PubMed  Google Scholar 

  19. Parker BS, Rautela J, Hertzog PJ. Antitumour actions of interferons: implications for cancer therapy. Nat Rev Cancer. 2016;16(3):131–44. https://doi.org/10.1038/nrc.2016.14.

    Article  PubMed  Google Scholar 

  20. Horvath CM. The Jak-STAT pathway stimulated by interferon alpha or interferon beta. Sci STKE. 2004;2004(260):tr10. https://doi.org/10.1126/stke.2602004tr10.

    PubMed  Google Scholar 

  21. Takahashi S, Tanigawa T, Imagawa M, Mimata H, Nomura Y, Ogata J. Interferon as adjunctive treatment for non-metastatic renal cell carcinoma. Br J Urol. 1994;74(1):11–4. https://doi.org/10.1111/j.1464-410X.1994.tb16537.x.

    Article  CAS  PubMed  Google Scholar 

  22. Pizzocaro G, Piva L, Colavita M, Ferri S, Artusi R, Boracchi P, et al. Interferon adjuvant to radical nephrectomy in Robson stages II and III renal cell carcinoma: a multicentric randomized study. J Clin Oncol. 2001;19(2):425–31. https://doi.org/10.1200/JCO.2001.19.2.425.

  23. Messing EM, Manola J, Wilding G, Propert K, Fleischmann J, Crawford ED, et al. Phase III study of interferon alfa-NL as adjuvant treatment for resectable renal cell carcinoma: an eastern cooperative oncology group/intergroup trial. J Clin Oncol. 2003;21(7):1214–22. https://doi.org/10.1200/JCO.2003.02.005.

  24. Liao W, Lin JX, Leonard WJ. Interleukin-2 at the crossroads of effector responses, tolerance, and immunotherapy. Immunity. 2013;38(1):13–25. https://doi.org/10.1016/j.immuni.2013.01.004.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Margolin KA. Interleukin-2 in the treatment of renal cancer. Semin Oncol. 2000;27(2):194–203.

    CAS  PubMed  Google Scholar 

  26. Clark JI, Atkins MB, Urba WJ, Creech S, Figlin RA, Dutcher JP, et al. Adjuvant high-dose bolus interleukin-2 for patients with high-risk renal cell carcinoma: a cytokine working group randomized trial. J Clin Oncol. 2003;21(16):3133–40. https://doi.org/10.1200/JCO.2003.02.014.

  27. Hong SK, Kwak C, Lee SE. Adjuvant interleukin-2, interferon-alpha, and 5-fluorouracil immunochemotherapy after radical nephrectomy for locally advanced renal cell carcinoma. Urology. 2005;66(3):518–22. https://doi.org/10.1016/j.urology.2005.04.014.

    Article  PubMed  Google Scholar 

  28. Atzpodien J, Schmitt E, Gertenbach U, Fornara P, Heynemann H, Maskow A, et al. Adjuvant treatment with interleukin-2- and interferon-alpha2a-based chemoimmunotherapy in renal cell carcinoma post tumour nephrectomy: results of a prospectively randomised trial of the German cooperative renal carcinoma Chemoimmunotherapy group (DGCIN). Br J Cancer. 2005;92(5):843–6. https://doi.org/10.1038/sj.bjc.6602443.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Aitchison M, Bray CA, Van Poppel H, Sylvester R, Graham J, Innes C, et al. Adjuvant 5-flurouracil, alpha-interferon and interleukin-2 versus observation in patients at high risk of recurrence after nephrectomy for renal cell carcinoma: results of a phase III randomised European Organisation for Research and Treatment of Cancer (Genito-urinary cancers group)/National Cancer Research Institute trial. Eur J Cancer. 2014;50(1):70–7. https://doi.org/10.1016/j.ejca.2013.08.019.

  30. Passalacqua R, Caminiti C, Buti S, Porta C, Camisa R, Braglia L, et al. Adjuvant low-dose interleukin-2 (IL-2) plus interferon-alpha (IFN-alpha) in operable renal cell carcinoma (RCC): a phase III, randomized, multicentre trial of the Italian oncology Group for Clinical Research (GOIRC). J Immunother. 2014;37(9):440–7. https://doi.org/10.1097/CJI.0000000000000055.

  31. Dillman RO, Nayak SK, Beutel L. Establishing in vitro cultures of autologous tumor cells for use in active specific immunotherapy. J Immunother Emphasis Tumor Immunol. 1993;14(1):65–9. https://doi.org/10.1097/00002371-199307000-00009.

    Article  CAS  PubMed  Google Scholar 

  32. Pomer S, Thiele R, Staehler G, Drehmer I, Lohrke H, Schirrmacher V. Tumor vaccination in renal cell carcinoma with and without interleukin-2 (IL-2) as adjuvant. A clinical contribution to the development of effective active specific immunization. Urologe A. 1995;34(3):215–20.

    CAS  PubMed  Google Scholar 

  33. Van Poppel H, Joniau S, Van Gool SW. Vaccine therapy in patients with renal cell carcinoma. Eur Urol. 2009;55(6):1333–42. https://doi.org/10.1016/j.eururo.2009.01.043.

    Article  PubMed  Google Scholar 

  34. Galligioni E, Francini M, Quaia M, Carbone A, Spada A, Sacco C, et al. Randomized study of adjuvant immunotherapy with autologous tumor cells and BCG in renal cancer. Ann N Y Acad Sci. 1993;690(1 Specific Immu):367–9. https://doi.org/10.1111/j.1749-6632.1993.tb44033.x.

    Article  CAS  PubMed  Google Scholar 

  35. Repmann R, Goldschmidt AJ, Richter A. Adjuvant therapy of renal cell carcinoma patients with an autologous tumor cell lysate vaccine: a 5-year follow-up analysis. Anticancer Res. 2003;23(2A):969–74.

    CAS  PubMed  Google Scholar 

  36. Jocham D, Richter A, Hoffmann L, Iwig K, Fahlenkamp D, Zakrzewski G, et al. Adjuvant autologous renal tumour cell vaccine and risk of tumour progression in patients with renal-cell carcinoma after radical nephrectomy: phase III, randomised controlled trial. Lancet. 2004;363(9409):594–9. https://doi.org/10.1016/S0140-6736(04)15590-6.

  37. Lebret T, Watson RW, Fitzpatrick JM. Heat shock proteins: their role in urological tumors. J Urol. 2003;169(1):338–46. https://doi.org/10.1016/S0022-5347(05)64123-7.

    Article  CAS  PubMed  Google Scholar 

  38. Srivastava P. Interaction of heat shock proteins with peptides and antigen presenting cells: chaperoning of the innate and adaptive immune responses. Annu Rev Immunol. 2002;20(1):395–425. https://doi.org/10.1146/annurev.immunol.20.100301.064801.

    Article  CAS  PubMed  Google Scholar 

  39. Ciocca DR, Calderwood SK. Heat shock proteins in cancer: diagnostic, prognostic, predictive, and treatment implications. Cell Stress Chaperones. 2005;10(2):86–103. https://doi.org/10.1379/CSC-99r.1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Tamura Y, Peng P, Liu K, Daou M, Srivastava PK. Immunotherapy of tumors with autologous tumor-derived heat shock protein preparations. Science. 1997;278(5335):117–20. https://doi.org/10.1126/science.278.5335.117.

    Article  CAS  PubMed  Google Scholar 

  41. Wood C, Srivastava P, Bukowski R, Lacombe L, Gorelov AI, Gorelov S, et al. An adjuvant autologous therapeutic vaccine (HSPPC-96; vitespen) versus observation alone for patients at high risk of recurrence after nephrectomy for renal cell carcinoma: a multicentre, open-label, randomised phase III trial. Lancet. 2008;372(9633):145–54. https://doi.org/10.1016/S0140-6736(08)60697-2.

  42. Yang JC. Vitespen: a vaccine for renal cancer? Lancet. 2008;372(9633):92–3. https://doi.org/10.1016/S0140-6736(08)60698-4.

    Article  PubMed  Google Scholar 

  43. De Maeseneer DJ, Delafontaine B, Rottey S. Checkpoint inhibition: new treatment options in urologic cancer. Acta Clin Belg. 2017;72(1):24–8. https://doi.org/10.1080/17843286.2016.1260890.

    Article  PubMed  Google Scholar 

  44. Motzer RJ, Escudier B, McDermott DF, George S, Hammers HJ, Srinivas S, et al. Nivolumab versus Everolimus in advanced renal-cell carcinoma. N Engl J Med. 2015;373(19):1803–13. https://doi.org/10.1056/NEJMoa1510665.

  45. • Harshman LC, Puligandla M, Haas NB, Allaf M, Drake CG, McDermott DF, et al. A phase III randomized study comparing perioperative nivolumab vs. observation in patients with localized renal cell carcinoma undergoing nephrectomy (PROSPER RCC). J Clin Oncol. 2017;35(15_suppl):TPS4596-TPS. Describes study design of PROSPER study

    Google Scholar 

  46. MacFarlane AW, Jillab M, Plimack ER, Hudes GR, Uzzo RG, Litwin S, et al. PD-1 expression on peripheral blood cells increases with stage in renal cell carcinoma patients and is rapidly reduced after surgical tumor resection. Cancer Immunol Res. 2014;2(4):320–31. https://doi.org/10.1158/2326-6066.CIR-13-0133.

  47. Jacobsen J, Grankvist K, Rasmuson T, Bergh A, Landberg G, Ljungberg B. Expression of vascular endothelial growth factor protein in human renal cell carcinoma. BJU Int. 2004;93(3):297–302. https://doi.org/10.1111/j.1464-410X.2004.04605.x.

    Article  CAS  PubMed  Google Scholar 

  48. Kaelin WG Jr. The von Hippel-Lindau tumor suppressor protein and clear cell renal carcinoma. Clin Cancer Res. 2007;13(2 Pt 2):680s–4s. https://doi.org/10.1158/1078-0432.CCR-06-1865.

    Article  CAS  PubMed  Google Scholar 

  49. Escudier B, Eisen T, Stadler WM, Szczylik C, Oudard S, Siebels M, et al. Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med. 2007;356(2):125–34. https://doi.org/10.1056/NEJMoa060655.

  50. Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Oudard S, et al. Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol. 2009;27(22):3584–90. https://doi.org/10.1200/JCO.2008.20.1293.

  51. Sonpavde G, Sternberg CN, Rosenberg JE, Hahn NM, Galsky MD, Vogelzang NJ. Second-line systemic therapy and emerging drugs for metastatic transitional-cell carcinoma of the urothelium. Lancet Oncol. 2010;11(9):861–70. https://doi.org/10.1016/S1470-2045(10)70086-3.

    Article  CAS  PubMed  Google Scholar 

  52. Motzer RJ, Hutson TE, Cella D, Reeves J, Hawkins R, Guo J, et al. Pazopanib versus sunitinib in metastatic renal-cell carcinoma. N Engl J Med. 2013;369(8):722–31. https://doi.org/10.1056/NEJMoa1303989.

  53. Motzer RJ, Escudier B, Tomczak P, Hutson TE, Michaelson MD, Negrier S, et al. Axitinib versus sorafenib as second-line treatment for advanced renal cell carcinoma: overall survival analysis and updated results from a randomised phase 3 trial. Lancet Oncol. 2013;14(6):552–62. https://doi.org/10.1016/S1470-2045(13)70093-7.

    Article  CAS  PubMed  Google Scholar 

  54. Haas NB, Manola J, Uzzo RG, Flaherty KT, Wood CG, Kane C, et al. Adjuvant sunitinib or sorafenib for high-risk, non-metastatic renal-cell carcinoma (ECOG-ACRIN E2805): a double-blind, placebo-controlled, randomised, phase 3 trial. Lancet. 2016;387(10032):2008–16. https://doi.org/10.1016/S0140-6736(16)00559-6.

  55. Haas NB, Manola J, Dutcher JP, Flaherty KT, Uzzo RG, Atkins MB, et al. Adjuvant treatment for high-risk clear cell renal cancer: updated results of a high-risk subset of the ASSURE randomized trial. JAMA Oncol. 2017;3(9):1249–52. https://doi.org/10.1001/jamaoncol.2017.0076.

  56. Ravaud A, Motzer RJ, Pandha HS, George DJ, Pantuck AJ, Patel A, et al. Adjuvant Sunitinib in high-risk renal-cell carcinoma after nephrectomy. N Engl J Med. 2016;375(23):2246–54. https://doi.org/10.1056/NEJMoa1611406.

  57. • Motzer RJ, Ravaud A, Patard JJ, Pandha HS, George DJ, Patel A, et al.. Adjuvant sunitinib for high-risk renal cell carcinoma after nephrectomy: subgroup analyses and updated overall survival results. Eur Urol. 2017. Reports updated results on disease free survival benefit with adjuvant sunitinib in S-TRAC trial.

  58. Motzer RJ, Haas NB, Donskov F, Gross-Goupil M, Varlamov S, Kopyltsov E, et al. Randomized phase III trial of adjuvant pazopanib versus placebo after nephrectomy in patients with locally advanced renal cell carcinoma (RCC) (PROTECT). J Clin Oncol. 2017;35(15_suppl):4507.

    Google Scholar 

  59. Xie J, Wang X, Proud CG. mTOR inhibitors in cancer therapy. F1000Res. 2016; 5.

  60. Shuch B, Li Z, Belldegrun AS. Carbonic anhydrase IX and renal cell carcinoma: prognosis, response to systemic therapy, and future vaccine strategies. BJU Int. 2008;101(Suppl 4):25–30. https://doi.org/10.1111/j.1464-410X.2008.07645.x.

    Article  CAS  PubMed  Google Scholar 

  61. Bleumer I, Knuth A, Oosterwijk E, Hofmann R, Varga Z, Lamers C, et al. A phase II trial of chimeric monoclonal antibody G250 for advanced renal cell carcinoma patients. Br J Cancer. 2004;90(5):985–90. https://doi.org/10.1038/sj.bjc.6601617.

  62. Bleumer I, Oosterwijk E, Oosterwijk-Wakka JC, Voller MC, Melchior S, Warnaar SO, et al. A clinical trial with chimeric monoclonal antibody WX-G250 and low dose interleukin-2 pulsing scheme for advanced renal cell carcinoma. J Urol. 2006;175(1):57–62. https://doi.org/10.1016/S0022-5347(05)00040-6.

    Article  CAS  PubMed  Google Scholar 

  63. Siebels M, Rohrmann K, Oberneder R, Stahler M, Haseke N, Beck J, et al. A clinical phase I/II trial with the monoclonal antibody cG250 (RENCAREX(R)) and interferon-alpha-2a in metastatic renal cell carcinoma patients. World J Urol. 2011;29(1):121–6. https://doi.org/10.1007/s00345-010-0570-2.

  64. Chamie K, Donin NM, Klopfer P, Bevan P, Fall B, Wilhelm O, et al. Adjuvant weekly Girentuximab following nephrectomy for high-risk renal cell carcinoma: the ARISER randomized clinical trial. JAMA Oncol. 2017;3(7):913–20. https://doi.org/10.1001/jamaoncol.2016.4419.

    Article  PubMed  Google Scholar 

  65. Weiss SA, Puligandla M, Jilaveanu L, Haas NB, Wang XV, Zito C, et al. Microvessel density as a prognostic marker in high-risk renal cell carcinoma. J Clin Oncol. 2017;35(15_suppl):4565.

    Google Scholar 

  66. • Rini B, Goddard A, Knezevic D, Maddala T, Zhou M, Aydin H, et al. A 16-gene assay to predict recurrence after surgery in localised renal cell carcinoma: development and validation studies. Lancet Oncol. 2015;16(6):676–685. Illustrates the development and validation of the 16-gene recurrence score. https://doi.org/10.1016/S1470-2045(15)70167-1.

  67. Escudier BJ RB, Martini J-F, et al.. Phase III trial of adjuvant sunitinib in patients with high-risk renal cell carcinoma (RCC): Validation of the 16-gene Recurrence Score in stage III patients. J Clin Oncol 35, 2017 (suppl; abstr 4508).

  68. Nonemacher HTS, Cordeiro M, Albuquerque GL, Galucci F, Carvalho PA, Borges L, et al. Oncological outcomes of positive surgical margins in partial nephrectomy for renal cell carcinoma. J Clin Oncol. 2017;35(15_suppl):e16079-e.

    Google Scholar 

  69. Khalifeh A, Kaouk JH, Bhayani S, Rogers C, Stifelman M, Tanagho YS, et al. Positive surgical margins in robot-assisted partial nephrectomy: a multi-institutional analysis of oncologic outcomes (leave no tumor behind). J Urol. 2013;190(5):1674–9. https://doi.org/10.1016/j.juro.2013.05.110.

  70. Mir MC, Derweesh I, Porpiglia F, Zargar H, Mottrie A, Autorino R. Partial nephrectomy versus radical nephrectomy for clinical T1b and T2 renal tumors: a systematic review and meta-analysis of comparative studies. Eur Urol. 2017;71(4):606–17. https://doi.org/10.1016/j.eururo.2016.08.060.

    Article  PubMed  Google Scholar 

  71. Jeong SH, Kim JK, Park J, Jeon HJ, Yoon MY, Jeong CW, et al. Pathological T3a upstaging of clinical T1 renal cell carcinoma: outcomes according to surgical technique and predictors of upstaging. PLoS One. 2016;11(11):e0166183. https://doi.org/10.1371/journal.pone.0166183.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Escudier Bea. CheckMate 214: efficacy and safety of nivolumab + ipilimumab (N+I) v sunitinib (S) for treatment-naïve advanced or metastatic renal cell carcinoma (mRCC), including IMDC risk and PD-L1 expression subgroups. ESMO Congress, Madrid, Spain, October 2017; LBA 5.

  73. Scher HI. Observed advantages of the STAMPEDE study design. Eur Urol. 2015;67(6):1039–41. https://doi.org/10.1016/j.eururo.2014.12.004.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Section of Hematology-Oncology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA

    Lakshminarayanan Nandagopal MD & Gurudatta Naik MBBS

  2. Department of Medical Oncology, Genitourinary Oncology Section, Dana-Farber Cancer Institute, 450 Brookline Avenue, D1230F, Boston, MA, 02215, USA

    Guru Sonpavde MD

Authors
  1. Lakshminarayanan Nandagopal MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gurudatta Naik MBBS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Guru Sonpavde MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guru Sonpavde MD.

Ethics declarations

Conflict of Interest

Lakshminarayanan Nandagopal declares that he has no conflict of interest.

Gurudatta Naik declares that he has no conflict of interest.

Guru Sonpavde is supported by grants to his institution from Boehringer-Ingelheim, Bayer, Onyx-Amgen, Merck, Pfizer, and Celgene; has served as a consultant for Pfizer, Genentech, Novartis, Merck, Sanofi, Astrazeneca, Exelixis, Bristol-Myers-Squibb, Janssen, Amgen, and the National Comprehensive Cancer Network (NCCN); has served as an author for Uptodate; and has served as a guest speaker for Physicians’ Education Resource (PER) and OncLive.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Genitourinary Cancers

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nandagopal, L., Naik, G. & Sonpavde, G. Overview of Current and Future Adjuvant Therapy for High-Risk Localized Renal Cell Carcinoma. Curr. Treat. Options in Oncol. 19, 2 (2018). https://doi.org/10.1007/s11864-018-0522-4

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11864-018-0522-4

Keywords

Search

Navigation