Consensus paper: current state of first- and second-line therapy in advanced clear-cell renal cell carcinoma

Author:

Goebell Peter J1ORCID,Ivanyi Philipp2,Bedke Jens3,Bergmann Lothar4,Berthold Dominik5,Boegemann Martin6,Busch Jonas7,Doehn Christian8,Krege Susanne9,Retz Margitta10,Amsberg Gunhild von11,Grimm Marc-Oliver12,Gruenwald Viktor13

Affiliation:

1. Division of Urology, University Hospital Erlangen, D-91054, Erlangen, Germany

2. Department of Hematology, Hemostaseology, Oncology & Stem Cell Transplantation, Hannover Medical School, D-30625, Hannover, Germany

3. Department of Urology, Eberhard Karls University, D-72076, Tuebingen, Germany

4. University Hospital Frankfurt, Medical Clinic II, D-60590, Frankfurt, Germany

5. Centre Hospitalier Universitaire Vaudois, CH-1011, Lausanne, Switzerland

6. Department of Urology, University Hospital Münster, D-48149, Münster, Germany

7. Department of Urology, Charité-University Medicine, D-10117, Berlin, Germany

8. Urologikum Lübeck, D-23566, Lübeck, Germany

9. Department of Urology, Pediatric Urology & Urologic Oncology, Kliniken Essen-Mitte, D-45136, Essen, Germany

10. Department of Urology, Technical University of Munich, Rechts der Isar Medical Center, D-81675, Munich, Germany

11. Department of Oncology & Hematology, University Cancer Center Hamburg & Martini-Clinic, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany

12. Department of Urology, Jena University Hospital, D-07747, Jena, Germany

13. Interdisciplinary GU Oncology, Clinic for Medical Oncology & Clinic for Urology, University Hospital Essen, D-45147, Essen, Germany

Abstract

The therapy of advanced (clear-cell) renal cell carcinoma (RCC) has recently experienced tremendous changes. Several new treatments have been developed, with PD-1 immune-checkpoint inhibition being the backbone of therapy. Diverse immunotherapy combinations change current first-line standards. These changes also require new approaches in subsequent lines of therapy. In an expert panel, we discussed the new treatment options and how they change clinical practice. While first-line immunotherapies introduce a new level of response rates, data on second-line therapies remains poor. This scenario poses a challenge for clinicians as guideline recommendations are based on historical patient cohorts and agents may lack the appropriate label for their in guidelines recommended use. Here, we summarize relevant clinical data and consider appropriate treatment strategies.

Publisher

Future Medicine Ltd

Subject

Cancer Research,Oncology,General Medicine

Reference75 articles.

1. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update

2. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

3. Updated European Association of Urology Guidelines on Renal Cell Carcinoma: Immune Checkpoint Inhibition Is the New Backbone in First-line Treatment of Metastatic Clear-cell Renal Cell Carcinoma

4. Bavencio (avelumab) www.ema.europa.eu/en/medicines/human/EPAR/bavencio

5. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): S3-Leitlinie Diagnostik, Therapie und Nachsorge des Nierenzellkarzinoms, Langversion 2.0 – August 2020, AWMF Registernummer: 043/017OL, www.leitlinienprogramm-onkologie.de/leitlinien/nierenzellkarzinom/

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