Genitourinary cancers represent 12.8% of cancer in both sexes and 21.5% in men, accounting for 7% of cancer deaths in both sexes and 10.5% in men. The systemic treatment of prostate cancer and renal cell carcinoma does not rely on chemotherapy, with the exception of taxane docetaxel and cabazitaxel. Prostate cancer is primarily treated by androgen deprivation, by surgical castration or LHRH analogs, or by androgen receptor pathway inhibitor enzalutamide and abiraterone acetate. Renal cell carcinoma is nowadays treated with agents targeting survival and angiogenesis pathways, including tyrosine kinase inhibitors (TKIs) sorafenib, sunitinib, axitinib, and pazopanib; anti-vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab; mammalian target of rapamycin (mTOR) inhibitors temsirolimus and everolimus; and oral inhibitor of tyrosine kinases MET, VEGFR, AXL, cabozantinib. Most recently, immune checkpoint inhibitors have made their way to genitourinary cancers, revolutionizing the treatment of urothelial cancers and renal cell carcinoma.
Hormone therapies and targeted therapies don’t eradicate prostate cancer and renal cell carcinoma but rather switch them to a more chronic state. This means that these treatments are prescribed chronically for an extended period of time. In such conditions, even the least bothersome side effect may profoundly alter the quality of life of patients. Ultimately, this is a threat to compliance and then to the efficacy of these treatments. In addition, many of the side effects of these drugs often overlap with common chronic illnesses such as diabetes, hypertension, hypercholesterolemia, heart failure, and osteoporosis. An exhaustive knowledge of these side effects, proper monitoring, and in-depth education of patients are key elements to secure the efficacy of these treatments.
Prostate cancer Renal cell carcinoma Androgen deprivation therapy Tyrosine kinase inhibitors mTOR inhibitors Side effects
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