Renal cell carcinoma

The landscape of the management of renal cell carcinoma has evolved substantially in the last decade, leading to improved survival in localised and advanced disease. We review the epidemiology, pathology, and diagnosis of renal cell carcinoma and discuss the evidence for current management strategies from localised to metastatic disease. Developments in adjuvant therapies are discussed, including use of pembrolizumab—the first therapy to achieve overall survival benefit in the adjuvant setting. The treatment of advanced disease, including landmark trials that have established immune checkpoint inhibition as a standard of care, are also reviewed. We also discuss the current controversies that exist surrounding the management of metastatic renal cell carcinoma, including the use of risk assessment models for disease stratification and treatment selection for frontline therapy. Management of non-clear cell renal cell carcinoma subtypes is also reviewed. Future directions of research, including a discussion of ongoing clinical trials and the need for reliable biomarkers to guide treatment in kidney cancer, are also highlighted.

Matthew Young, MD, Francesca Jackson-Spence, MBChB, Luis Beltran, MD, Elizabeth Day, PhD, Christina Suarez, MD, Prof Axel Bex, MD, Prof Thomas Powles, MD, Bernadett Szabados, MD

Barts Cancer Institute, Queen Mary University of London, London, UK; Department of Cellular Pathology, Barts National Health Service Trust, London, UK; Department of Urology, University College London Hospital National Health Service Foundation Trust, London, UK; Medical Oncology, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Urology, The Royal Free London National Health Service Foundation Trust, University College London Division of Surgery and Interventional Science, London, UK; The Netherlands Cancer Institute, Amsterdam, Netherlands; Department of Urology, University College London Hospital National Health Service Foundation Trust, London, UK.

Source: Young M, Jackson-Spence F, Beltran L. et al. Renal cell carcinoma. The Lancet. 2024. DOI:https://doi.org/10.1016/S0140-6736(24)00917-6.

Login